Prognostic accuracy of head computed tomography for prediction of functional outcome after out-of-hospital cardiac arrest: Rationale and design of the prospective TTM2-CT-substudy

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Prognostic accuracy of head computed tomography for prediction of functional outcome after out-of-hospital cardiac arrest : Rationale and design of the prospective TTM2-CT-substudy

Lang, Margareta (författare): Lund University,Lunds universitet,Kliniska Vetenskaper, Helsingborg,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Clinical Sciences, Helsingborg,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Helsingborg Hospital

Leithner, Christoph (författare): Charite Univ Med Berlin, Dept Neurol & Expt Neurol, Berlin, Germany.,Charité - University Medicine Berlin

Scheel, Michael (författare): Charite Univ Med Berlin, Dept Neuroradiol, Berlin, Germany.,Charité - University Medicine Berlin

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Kenda, Martin (författare): Charite Univ Med Berlin, Dept Neurol & Expt Neurol, Berlin, Germany.;Charite Univ Med Berlin, Berlin Inst Hlth, Berlin, Germany.,Berlin Institute of Health (BIH),Charité - University Medicine Berlin

Cronberg, Tobias (författare): Lund University,Lunds universitet,Brain Injury After Cardiac Arrest,Forskargrupper vid Lunds universitet,Lund University Research Groups,Skåne University Hospital

During, Joachim (författare): Lund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital

Rylander, Christian (författare): Uppsala University,Uppsala universitet,Anestesiologi och intensivvård,Uppsala Univ, Sweden

Annborn, Martin (författare): Lund University,Lunds universitet,Kliniska Vetenskaper, Helsingborg,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Clinical Sciences, Helsingborg,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Helsingborg Hospital

Dankiewicz, Josef (författare): Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital

Deye, Nicolas (författare): Lariboisiere Hosp, Dept Med & Toxicol Intens Care Unit, Paris, France.,Lariboisière Hospital

Halliday, Thomas (författare): Linköping Univ Hosp, Dept Operat & Intens Care, Linköping, Sweden.,Region Östergötland, ANOPIVA US,Linköping University Hospital

Lascarrou, Jean-Baptiste (författare): Univ Hosp Ctr, Med Intens Reanimat, Nantes, France.,Nantes University Hospital

Matthew, Thomas (författare): Univ Hosp, Intens Care Unit, Bristol, Avon, England.;Univ Hosp, Intens Care Unit, Weston, England.,University Hospitals, England, Bristol and Weston

McGuigan, Peter (författare): Royal Victoria Hosp, Reg Intens Care Unit, Belfast, Antrim, North Ireland.,Royal Victoria Hospital, Belfast

Morgan, Matt (författare): Royal Perth Hosp, Dept Intens Care, Perth, WA, Australia.;Univ Hosp Wales, Dept Intens Care, Cardiff, Wales.;Curtin Univ, Sch Med, Perth, WA, Australia.,Curtin University,University Hospital of Wales,Royal Perth Hospital

Thomas, Matthew (författare): Univ Hosp, Bristol, Avon, England.;Univ Hosp, Weston, England.

Ullén, Susann (författare): Skane Univ Hosp, Clin Studies Sweden Forum South, Lund, Sweden.,Skåne University Hospital

Undén, Johan (författare): Lund University,Lunds universitet,Anestesiologi och intensivvård,Forskargrupper vid Lunds universitet,Anaesthesiology and Intensive Care Medicine,Lund University Research Groups,Halmstad County Hospital

Nielsen, Niklas (författare): Lund University,Lunds universitet,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,Center for cardiac arrest,Lund University Research Groups,Helsingborg Hospital

Moseby-Knappe, Marion (författare): Lund University,Lunds universitet,Brain Injury After Cardiac Arrest,Forskargrupper vid Lunds universitet,Lund University Research Groups,Skåne University Hospital

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Elsevier, 2022
2022
Engelska.
Ingår i: Resuscitation Plus. - : Elsevier. - 2666-5204. ; 12

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Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

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Background: Head computed tomography (CT) is a guideline recommended method to predict functional outcome after cardiac arrest (CA), but standardized criteria for evaluation are lacking. To date, no prospective trial has systematically validated methods for diagnosing hypoxic-ischaemic encephalopathy (HIE) on CT after CA. We present a protocol for validation of pre-specified radiological criteria for assessment of HIE on CT for neuroprognostication after CA.Methods/design: This is a prospective observational international multicentre substudy of the Targeted Hypothermia versus Targeted Normother-mia after out-of-hospital cardiac arrest (TTM2) trial. Patients still unconscious 48 hours post-arrest at 13 participating hospitals were routinely exam-ined with CT. Original images will be evaluated by examiners blinded to clinical data using a standardized protocol. Qualitative assessment will include evaluation of absence/presence of "severe HIE". Radiodensities will be quantified in pre-specified regions of interest for calculation of grey-white matter ratios (GWR) at the basal ganglia level. Functional outcome will be dichotomized into good (modified Rankin Scale 0-3) and poor (modified Rankin Scale 4-6) at six months post-arrest. Prognostic accuracies for good and poor outcome will be presented as sensitivities and speci-ficities with 95% confidence intervals (using pre-specified cut-offs for quantitative analysis), descriptive statistics (Area Under the Receiver Operating Characteristics Curve), inter-and intra-rater reliabilities according to STARD guidelines.Conclusions: The results from this prospective trial will validate a standardized approach to radiological evaluations of HIE on CT for prediction of functional outcome in comatose CA patients.The TTM2 trial and the TTM2 CT substudy are registered at ClinicalTrials.gov NCT02908308 and NCT03913065.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)

Nyckelord

Neuroprognostication
Computed tomography
Hypoxic-ischaemic encephalopathy (HIE)
Cardiac arrest
Targeted temper-ature management
Outcome
GWR grey-white matter ratio
Cardiac arrest
Computed tomography
GWR grey-white matter ratio
Hypoxic-ischaemic encephalopathy (HIE)
Neuroprognostication
Outcome
Targeted temperature management

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