A new research study from Cooper University Health Care, led by Brian N. Roberts, MD, and his colleagues, has been published in Circulation, the premier biomedical journal for cardiovascular disease. The paper entitled “Association Between Post-resuscitation Partial Pressure of Arterial Carbon Dioxide and Neurological Outcome in Patients With Post–Cardiac Arrest Syndrome” appears in the May 28 issue.
When a cardiac arrest occurs, a patient’s heart stops beating entirely, and the brain is deprived of blood flow. Even if cardiopulmonary resuscitation can get the heart restarted, the majority of patients go on to die in the hospital or survive with crippling neurological disability due to permanent brain damage. To date, the only proven treatment to reduce or prevent brain damage after cardiac arrest has been therapeutic hypothermia, a treatment strategy where the body is cooled to 93º F or less as fast as possible. Roberts and colleagues believe another important factor in determining the degree of brain damage after resuscitation may be the level of carbon dioxide in the blood.
Carbon dioxide is a major regulator of the amount of blood flow circulating to the brain; and, in theory carbon dioxide abnormalities after resuscitation can cause abnormalities in blood flow to the brain, worsening brain damage. In the new study, Roberts found that abnormally low and high carbon dioxide levels in the blood after resuscitation were both associated with worse neurological function at hospital discharge. The main determinant of the level of carbon dioxide in the blood is the manner in which patients are mechanically ventilated.
“Ultimately, we believe that rapid normalization of blood carbon dioxide levels through early optimization of mechanical ventilation may reduce brain injury; however, more research is needed”, Roberts said.
Roberts and Stephen W. Trzeciak, MD, MPH, a critical care and emergency medicine specialist at Cooper and a collaborator on the current study, plan to continue this line of research at Cooper and five other centers across the United States as part of a $2.4 million research project grant (R01) that Trzeciak recently received from the National Institutes of Health to study cognitive function after cardiac arrest.
Cooper University Hospital is a regional referral center for cardiac arrest victims. Local hospitals transfer their patients to the Cooper Resuscitation Center for post-cardiac arrest care. Cooper has been a leader in the use of therapeutic hypothermia to reduce brain injury after cardiac arrest for more than five years and has been involved in several studies measuring outcomes of this technique.
“Dr. Roberts’ new study is an important contribution to the field of resuscitation science.” said John P. Sheridan, Jr., President and CEO of The Cooper Health System. “We are proud to be a leader in medical research and our continuing efforts to analyze new life-saving modalities of care.”