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This feasibility study explores the possibilities to use microdialysis (MD) for continuous monitoring of cerebral energy metabolism by analyzing the draining cerebral venous blood. Eighteen comatose patients were continuously monitored with jugular bulb and radial artery (reference) MD following resuscitation. Median time from cardiac arrest to MD was 300\u00a0min (IQR 230\u2013390) with median monitoring time 60\u00a0h (IQR 40\u201381). The lactate\/pyruvate ratio in cerebral venous blood was increased during the first 20\u00a0h after OHCA, and significant differences in time-averaged mean MD metabolites between jugular venous and artery measurements, were documented (p\u2009&lt;\u20090.02). In patients with unfavorable outcome (72%), cerebral venous lactate and pyruvate levels remained elevated during the study period. In conclusion, the study indicates that jugular bulb microdialysis (JBM) is feasible and safe. Biochemical signs of lasting ischemia and mitochondrial dysfunction are frequent and associated with unfavorable outcome. 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