Molecular Insights Into Post-Cardiac Arrest Brain Injury Via CSF Multi-Omics

Identification of Novel Molecular Pathophysiological Mechanisms of Secondary Brain Injury in Post-cardiac Arrest Syndrome Patients Using Cerebrospinal Fluid Multi-omics Analysis

The goal of this study is to uncover the molecular mechanisms responsible for secondary brain injury in patients with post-cardiac arrest syndrome by analyzing cerebrospinal fluid (CSF) using multi-omics techniques.

The main question this study aims to answer is:

Which genome-, transcriptome-, proteome-, and metabolome-level changes in CSF are associated with secondary brain injury after cardiac arrest?

To address this question, CSF samples collected from post-cardiac arrest patients will undergo multi-omics analyses. Identified molecular pathways will be used to screen existing drug databases and generate new therapeutic candidates through computational modeling and compound synthesis. These findings will provide the scientific foundation needed to design and implement future preclinical experiments using cardiac arrest animal models.

Inclusion Criteria:

• Patients receiving post-resuscitation care after out-of-hospital cardiac arrest for secondary brain injury treatment.
• Patients without contraindications for lumbar puncture catheter insertion for cerebrospinal fluid (CSF) collection. This includes the absence of:
• Uncontrolled diabetes.Coagulation disorders.
• Thrombocytopenia (platelet count $< 100,000).
• A history of cirrhosis diagnosis.
• Current receipt of low molecular weight heparin.
• Current use of platelet inhibitors.
• A history of posterior spinal fusion that may interfere with catheter insertion.
• Local skin infection or rash at the puncture site.
• Signs of systemic infection or sepsis.
• A history of lumbar puncture within the past 6 hours.

Exclusion Criteria:

• Cerebral Edema: Patients with evidence of cerebral edema on a brain computed tomography (CT) scan performed immediately after spontaneous circulation recovery.
• Patients who underwent extracorporeal membrane oxygenation (ECMO).
• Patients who could not maintain integrated therapy for more than 24 hours after cardiac arrest.
• Patients with a history of acute or chronic brain disease.