Regional Cerebral Perfusion after Automated Head-Up Cardiopulmonary Resuscitation using MRI

Motivation: The physiological underpinnings of improved neurological survival following cardiac arrest when using automated head up CPR (AHUP-CPR) are unknown. Goal(s): Explore longitudinal and regional differences in perfusion with AHUP-CPR compared to conventional CPR (C-CPR) in a swine model using pseudo-continuous arterial spin labeling (PCASL). Approach: PCASL was performed before ventricular fibrillation and CPR and 1 and 4 hours after CPR. Animals were randomized to receive AHUP-CPR or C-CPR. Segmentation and atlas matching allowed tissue and region-specific analysis. Results: Several significant differences were observed between tissue and regional perfusion results summarized by higher post recovery perfusion in the AHUP-CPR cohort. Impact: The impact of active head up CPR on regional cerebral perfusion after return of spontaneous circulation will improve our understanding of the mechanisms responsible for the neurological survival benefits compared to conventional CPR.