J Korean Soc Emerg Med.  2003 Mar;14(1):78-82.

The Usefulness of Proton Magnetic Resonance Spectroscopy in Comatose Patients after Successful Cardiopulmonary Resuscitation

• Hong TY
• Kim YM
• Choi SP
• Park KN
• Kim SK
• Ann GJ

Abstract

PURPOSE
The objective of this study was to investigate whether proton magnetic resonance spectroscopy (1H-MRS) is useful in the prediction of the neurological outcome for comatose patients after successful cardiopumonary resuscitation (CPR).
METHODS
We prospectively studied 22 patients with a comatose mentality existing for longer than 1 day after cardiac arrest. 1H-MRS examinations were scheduled to be performed within 5 days after restoration of spontaneous circulation (ROSC). All 1H-MRS readings were performed by a neuro-radiologist blindly. The best cerebral performance category (CPC) during 6 months after ROSC was used as the final outcome and classified as good (CPC 1-2) or poor (CPC 3-5).
RESULTS
Elevated cerebral lactate resonances were found in 14 patients. All of the 14 lactate-positive patients experienced a poor outcome. Five of the 8 lactate-negative patients recovered without neurologic defects, but three of them suffered from severe neurologic defects. The elevated cerebral lactate resonance distinguished between good out-comes (n=5) and poor outcomes (n=17) with three false negatives (sensitivity 82%) and no false positives (specificit y 100%). Demonstration of brain lactate in 1H-MRS (p < 0.05) proved to be significant in terms of a poor prognosis.
CONCLUSION
1H-MRS is of great benefit in the prognostic evaluation of comatose patients with anoxic-ischemic encephalopathy after successful CPR.

Keyword

Cardiopulmonary resuscitation; Proton magnetic resonance spectroscopy

MeSH Terms

Brain
Cardiopulmonary Resuscitation*
Coma*
Heart Arrest
Humans
Hypoxia-Ischemia, Brain
Lactic Acid
Magnetic Resonance Spectroscopy*
Prognosis
Prospective Studies
Protons*
Reading
Resuscitation
Lactic Acid
Protons