Augmented Multimodal Neurologic Monitoring in High Risk Survivors of Cardiac Arrest

Not Applicable

Terminated

Interventions: Device: QFlow 500™ Perfusion Probe (Hemedex, Cambridge, MA)
Device: Spencer Probe Depth Electrode (Ad-Tech Medical, Racine, WI)

Brief Summary: Cardiac arrest is the most common cause of death in the United States and as many as 590,000 Americans suffering a cardiac arrest each year. Despite advances in care, as many as 50 to 89% of patients who are resuscitated after a cardiac arrest die in the hospital. Brain injury is the most common cause of death and disability after cardiac arrest. The investigators use advanced brain monitoring in patients who are at high risk of death after cardiac arrest, with the goal of preventing ongoing brain injury. The most common problem the investigators have observed is low oxygen levels in the brain, which is often very difficult to treat.

In this study, the investigators plan to use two additional brain monitors in the care of these high risk patients: a monitor for seizures and a monitor of the amount of blood flow in the brain. The investigators will use these to detect and treat potential causes of low brain oxygen levels. The main hypotheses are that electrical events in the brain such as seizures and "spreading depolarizations" will occur during times of low brain tissue oxygen level, and that treating these events and low blood flow will reduce the rate of low brain oxygen levels.

Recruitment & Eligibility

Inclusion Criteria

High risk survivors of cardiac arrest
Decision by potential subject's clinical team to use our institutional standard invasive, multimodal neurologic monitoring for post-arrest care

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
Cardiac arrest	Spencer Probe Depth Electrode (Ad-Tech Medical, Racine, WI)	Survivors of cardiac arrest at high risk of neurological deterioration. Participants will undergo placement of a Spencer Probe Depth Electrode and QFlow 500™ Perfusion Probe in addition to the institutional standard multimodal neurological monitoring.
Cardiac arrest	QFlow 500™ Perfusion Probe (Hemedex, Cambridge, MA)	Survivors of cardiac arrest at high risk of neurological deterioration. Participants will undergo placement of a Spencer Probe Depth Electrode and QFlow 500™ Perfusion Probe in addition to the institutional standard multimodal neurological monitoring.

Primary Outcome Measures

Name	Time	Method
Occult Seizures	Participants will be followed for the duration of invasive monitoring, an expected average of 5 days	Seizures detected by intracortical EEG but not surface EEG
Spreading Depolarizations	Participants will be followed for the duration of invasive monitoring, an expected average of 5 days
Cerebral Hypoperfusion	Participants will be followed for the duration of invasive monitoring, an expected average of 5 days

Secondary Outcome Measures

Name	Time	Method
Device Malfunction	Participants will be followed for the duration of invasive monitoring, an expected average of 5 days
Monitor-associated Infection	Participants will be followed for the duration of the initial hospitalization, an expected average of 2 weeks
Clinically Significant Bleeding	Participants will be followed for the duration of the initial hospitalization, an expected average of 2 weeks