Sunday, October 29, 2017

Early head CT post cardiac arrest



Aim

Neurological emergencies can lead to cardiac arrest, and post-arrest patients can develop life-threatening neurological abnormalities. This study aims to estimate and characterize the use of early head CT (HCT), and its potential impact on post-resuscitation management.

Methods

This retrospective study analyzed 213 adults who suffered an out-of-hospital cardiac arrest (OHCA) and survived for at least 24 h. Demographics were collected and arrest-related variables were documented. Timing of HCT was recorded and if abnormalities were found on HCT within 24 h of resuscitation, any resulting changes in management were recorded. Outcome was measured by cerebral performance category at discharge.

Results

Only 54% of patients who survived OHCA underwent HCT in the first 24 h after resuscitation. Patients who underwent HCT were healthier and had better pre-arrest functional status and shorter duration of arrest. Acute abnormalities were found on 38% of HCT and 34% of these abnormal scans resulted in management changes.

Conclusions

Early HCT is not consistently performed after OHCA and may be heavily influenced by a patient’s premorbid status and duration of arrest. Early HCT can demonstrate acute abnormalities that can result in significant changes in patient management.

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