{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T17:38:43Z","timestamp":1790876323809,"version":"4.1.0"},"reference-count":29,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T00:00:00Z","timestamp":1724630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011744","name":"National University Health System","doi-asserted-by":"publisher","award":["NUHSRO\/2019\/054\/RO5+5\/Seed-Mar\/07"],"award-info":[{"award-number":["NUHSRO\/2019\/054\/RO5+5\/Seed-Mar\/07"]}],"id":[{"id":"10.13039\/501100011744","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011744","name":"National University Health System","doi-asserted-by":"publisher","award":["MOH-001146"],"award-info":[{"award-number":["MOH-001146"]}],"id":[{"id":"10.13039\/501100011744","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001349","name":"National Medical Research Council","doi-asserted-by":"publisher","award":["NUHSRO\/2019\/054\/RO5+5\/Seed-Mar\/07"],"award-info":[{"award-number":["NUHSRO\/2019\/054\/RO5+5\/Seed-Mar\/07"]}],"id":[{"id":"10.13039\/501100001349","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001349","name":"National Medical Research Council","doi-asserted-by":"publisher","award":["MOH-001146"],"award-info":[{"award-number":["MOH-001146"]}],"id":[{"id":"10.13039\/501100001349","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>We assessed the feasibility of concurrent monitoring of cerebral hemodynamics in adult, comatose out-of-hospital cardiac arrest (OHCA) patients admitted to the National University Heart Centre Singapore from October 2021 to August 2023. Patients underwent continuous near-infrared spectroscopy (NIRS) monitoring in the first 72 h after return of spontaneous circulation (ROSC) and 30-min transcranial Doppler ultrasound (TCD) monitoring at least once. With constant mechanical ventilatory settings and continuous electrocardiographic, pulse oximeter and end-tidal carbon dioxide monitoring, blood pressure was manipulated via vasopressors and cerebral autoregulation assessed by measuring changes in regional cerebral oxygenation (NIRS) and cerebral blood flow velocities (TCD) in response to changes in mean arterial pressure. The primary outcome was neurological recovery at hospital discharge. Amongst the first 16 patients (median age 61, 94% males), we observed four unique patterns: preserved cerebral autoregulation, loss of cerebral autoregulation, cardio-cerebral asynchrony and cerebral circulatory arrest. Patients with preserved cerebral autoregulation had lower levels of neuro-injury biomarkers (neurofilaments light and heavy) and the majority (86%) were discharged with good neurological recovery. Multi-modal assessment of cerebral hemodynamics after OHCA is feasible and derived patterns correlated with neurological outcomes. The between- and within-patient heterogeneity in cerebral hemodynamics calls for more research on individualized treatment strategies.<\/jats:p>","DOI":"10.3390\/life14091067","type":"journal-article","created":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T07:53:37Z","timestamp":1724658817000},"page":"1067","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Multi-Modal Assessment of Cerebral Hemodynamics in Resuscitated Out-of-Hospital Cardiac Arrest Patients: A Case-Series"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1151-2357","authenticated-orcid":false,"given":"Shir Lynn","family":"Lim","sequence":"first","affiliation":[{"name":"Department of Cardiology, National University Heart Centre, Singapore 119228, Singapore"},{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore"},{"name":"Pre-Hospital and Emergency Research Centre, Duke-NUS Medical School, Singapore 169857, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"May Zin","family":"Myint","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine, National University Hospital, Singapore 119074, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai Lee","family":"Woo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National University Heart Centre, Singapore 119228, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine Young Heng","family":"Chee","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine, National University Hospital, Singapore 119074, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiew Sie","family":"Hong","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine, National University Hospital, Singapore 119074, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erta","family":"Beqiri","sequence":"additional","affiliation":[{"name":"Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 1TN, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5096-3938","authenticated-orcid":false,"given":"Peter","family":"Smielewski","sequence":"additional","affiliation":[{"name":"Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 1TN, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7874-7612","authenticated-orcid":false,"given":"Marcus Eng Hock","family":"Ong","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Singapore General Hospital, Singapore 169608, Singapore"},{"name":"Health Services and Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8976-5696","authenticated-orcid":false,"given":"Vijay Kumar","family":"Sharma","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore"},{"name":"Division of Neurology, Department of Medicine, National University Hospital, Singapore 119074, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2126","DOI":"10.1007\/s00134-004-2425-z","article-title":"Mode of death after admission to an intensive care unit following cardiac arrest","volume":"30","author":"Laver","year":"2004","journal-title":"Intensive Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S366","DOI":"10.1161\/CIR.0000000000000916","article-title":"Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care","volume":"142","author":"Panchal","year":"2020","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1007\/s00134-021-06368-4","article-title":"European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2021: Post-resuscitation care","volume":"47","author":"Nolan","year":"2021","journal-title":"Intensive Care Med"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2362","DOI":"10.1097\/CCM.0b013e318255d983","article-title":"Effects of prolonged mild hypothermia on cerebral blood flow after cardiac arrest","volume":"40","author":"Bisschops","year":"2012","journal-title":"Crit. 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