When to Call a Code: Using Transcranial Doppler to Anticipate Cardiac Arrest a Case Report

ABSTRACT Background Cardiac arrest often leads to mortality or neurological impairment. We have limited expertise in using noninvasive brain neuromonitoring to guide brain‐based resuscitation targets in CPR or as a biomarker to anticipate cardiac arrest. Case Summary 13‐day‐old neonate with severe hypoplastic right heart syndrome underwent aortopulmonary shunt placement, followed by cardiac arrest. Serial transcranial color‐coded duplex (TCCD), blood gases, and continuous bilateral cerebral saturation prior to cardiac arrest were collected and analyzed. Conclusion In our patient, TCCD demonstrated a sudden decrease in diastolic flow that preceded cardiac arrest. The loss of diastolic flow on TCCD can be an ominous sign that can trigger earlier resuscitative measures.