Prognostic Value of Computed Tomography Score in Patients After Extracorporeal Cardiopulmonary Resuscitation

Jeong-Am Ryu; Young Hwan Lee; Chi Ryang Chung; Yang Hyun Cho; Kiick Sung; Kyeongman Jeon; Gee Young Suh; Taek Kyu Park; Joo Myung Lee; Minjung Kathy Chae; Jeong-Ho Hong; Sei Hee Lee; Hyoung Soo Kim; Jeong Hoon Yang


Crit Care. 2018;22(323) 

In This Article


Neurological outcome is an important issue in patients who survive cardiac arrest. In these survivors, several predictors of neurological outcomes, such as physical examination, several biomarkers, and electrophysiologic studies, have been reported.[1,2] Brain imaging might also be helpful for predicting neurological outcomes after cardiac arrest.[3,4] Acute hypoxic-ischemic injury might be manifested by loss of gray-white matter discrimination, brain swelling, or low-density lesions on brain computed tomography (CT).[5,6] However, these changes in brain CT are likely to be subjective and difficult to quantify.[7] The Alberta Stroke Program Early Computed Tomography Score (ASPECTS) is a widely used screening tool that provides a framework for quantifying the extent of ischemic hypodensity or hypoattenuation in the middle cerebral arterial (MCA) territory.[8] In the setting of conventional cardiopulmonary resuscitation (CPR), ASPECTS with some modifications has been found to be useful to predict neurological outcomes of post-cardiac arrest patients.[9,10] However, whether ASPECTS might be helpful to systemically estimate neurological outcomes of survivors after extracorporeal cardiopulmonary resuscitation (ECPR) has not been reported. Therefore, the objective of this study was to investigate whether ASPECTS with some modifications could be used to predict neurological outcomes of patients after ECPR.