Objectives: We investigated the relationship between the duration of cardiopulmonary resuscitation (CPR) and the severity of injury of the ascending reticular activating system (ARAS) in patients with hypoxic-ischemic brain injury (HI-BI) after cardiac arrest by using diffusion tensor tractography (DTT).
Methods: Fifteen consecutive patients with HI-BI after cardiac arrest and 15 control subjects were recruited. Clinical status was evaluated by determining Glasgow coma scale (GCS), coma recovery scale-revised (CRS-R), and mini-mental state examination (MMSE) values. Three portions (lower dorsal, lower ventral, and upper portions) of the ARAS were reconstructed via DTT, and fractional anisotropy (FA) and tract volume (TV) values were determined.
Results: The FA and TV values for the three portions of the ARAS were significantly different between the patient and control groups (p > 0.05). CPR duration was significantly negatively correlated with GCS (r = −0.629, p < 0.05), moderately negatively correlated with CRS-R (r = −0.597, p < 0.05) and moderately negatively correlated with MMSE (r = −0.526, p < 0.05). In contrast, among the DTT parameters, only the TV value of the lower dorsal ARAS showed a moderately negative correlation with CPR duration (r = −0.464, p < 0.05).
Conclusions: We detected close relationships between CPR duration and injury severity in the lower dorsal ARAS in patients with HI-BI after cardiac arrest. Our results suggest that DTT-based analysis of the ARAS could be useful in patients with HI-BI after cardiac arrest.
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