Approaching brain injury after cardiac arrest: from bench to bedside

The neurological injury after resuscitation from cardiac arrest (CA) is a major cause of morbidity and mortality. The unavailability of primary brain directed measures of injury and effective therapy worsens the problem. We have embarked on better understanding the process of injury and recovery by developing an animal model in our laboratory. Using this model, we have discovered that the use of quantitative EEG (Q-EEG) analysis will allow us to titrate the brain injury, monitor the recovery process, study the electrophysiological and biochemical mechanisms of injury and recovery and detect the neuroprotective effect afforded by a drug that prevents neuronal death after injury. With ideas derived from the laboratory research, we have designed a study to test the applicability of QEEG analysis in human subjects resuscitated from cardiac arrest. Our preliminary analysis shows that our measure is able to track the neurological changes of these patients. With this very promising start of this QEEG based measure, we can utilize this technology to develop more rational and effective therapeutic strategies that will improve the neurological outcome in this patient population.