The association of findings on brain computed tomography with neurologic outcomes following extracorporeal cardiopulmonary resuscitation

Background: Limited data are available on imaging predictors of neurological outcomes after extracorporeal cardiopulmonary resuscitation (ECPR). We investigated the association of initial brain computed tomography (CT) findings with neurological outcomes following ECPR. Methods: Between February 2005 and December 2015, a total of 42 patients who underwent brain CT scans within 48 hours after ECPR were analyzed. Loss of the boundary between gray matter and white matter (LOB) or cortical sulcal effacement (SE), gray-to-white matter ratio (GWR), and optic nerve sheath diameter (ONSD) were measured on initial brain CT. The primary outcome was the Cerebral Performance Categories (CPC) scale at discharge. Conclusions: GWR, ONSD and LOB/SE on initial brain CT scans are associated with neurological prognosis in patients who underwent ECPR. A risk prediction model using a composite of GWR, ONCD, and LOB/SE could provide better information on neurologic outcomes in patients who underwent ECPR.