Transorbital Ultrasound and Other Markers for Prognosis Prediction After Cardiac Arrest

Transorbital Ultrasound and Other Markers for Prognosis Prediction After Cardiac Arrest (TOMCAT)

In sudden cardiac arrest patients with return of spontaneous circulation, brain damage is one of the main determinants of short-term mortality and poor prognosis (CPC 3-5). It is important to properly select group of patients in whom treatment is futile. According to current guidelines, multimodal approach is recommended. Optic nerve sheath diameter measured by ultrasound is non-invasive, fast, low-cost and readily available bed-side method, but evidence for its use as neuroprognostication modality is limited to only few small studies. The aim of this study is to evaluate validity of ONSD as neuroprognostication method at larger cohort of patients, compare it with other established methods and compare ultrasound and CT measurement of ONSD.

Additional relevant MeSH terms:

cardiac arrest, cardiovascular diseases, optic nerve sheath diameter.

Inclusion Criteria:

• age of 18 years or older
• out of hospital cardiac arrest of non-traumatic cause with CPR and subsequent ROSC
• Glasgow coma scale (GCS) ≤ 7 or sedation 30 minutes after ROSC achievment

Exclusion Criteria:

• unavailable first measurment of the optic nerve sheath diameter (ONSD) measured by transorbital ultrasonography 24±6 hours after ROSC achievement
• refractory cardiac arrest
• craniocerebral injury
• intracranial tumor
• active intracranial bleeding
• haemorrhagic stroke and/or subarachnoid haemorrhage in the last 3 months
• facial trauma affecting the eye area
• active neuroendocrine tumor, small cell lung cancer, non-small cell lung
• CPC 3-5 before cardiac arrest
• sclerosis multiplex and/or optic neuritis of other etiology