Maayke Hunfeld

61 Review neuromonitoring Results Morta- lity (%) Limitations Grade -All 5 patients with normal DWI good outcome (P=0.05) N=15 abnormal DWI: 7 good outcome -High intensity on DWI in cortex, basal ganglia and cerebellumassociated with poor outcome (P<0.05) -Degree of ADC decrease proportional to degree of cytotoxic oedema and poor prognosis 30% -Retrospective -Small cohort -MRI only performed when clinically indicated -Crude outcome scale -Hypothermia in N=3 and no temperature management in n=17 -Timing MRI different 2B/C (‘hypothesis- generating study on outcome’) -Global decreased ADC values are associated with poor outcome (P=0.02) -No difference in CBF by ASL between outcome groups -Brain regions with decreased ADC frequently had an increase in CBF 36% -Small cohort -No ADC or CBF data are known from healthy controls -Values can vary over development, this is not compensated in this study -Short and crude outcome -Timing MRI different -MRI only if clinically indicated 2B/C 2 ADC thresholds were found: -If ≥ 7% of brain volume had an ADC <600 X10 -6 mm 2 /s or if ≥ 11% of brain volume had an ADC <650 X 10 -6 mm 2 /s the odds ratio of poor outcome was 112 (95% CI 5-2611), specificity 1.0 (0.76-1.0 95% CI), sensitivity 0.8 (0.44-0.96 95% CI) -ROC analysis: ADC thresholds of <600 X10 -6 mm 2 /s and <650 X10 -6 mm 2 /s are good predictors of poor outcome with AUC of resp 0.95 (95% CI 0.88-1.0) and 0.95 (95% CI 0.87- 1.0) Duration of CPR, witnessed CA and cause of CA were individually predictors of outcome 27% -Retrospective -Small cohort -MRI only performed when neurologically impaired -Crude outcome scale at 6 months - 19% pre arrest PCPC score of 3-4 -Clinicians non blinded for qualitative MRI results -No validated thresholds -Timing MRI varies which might cause variability in ADC results 2B? 2