Multiomics Profiling of CSF in Cardiac Arrest Survivors

N/AActive Not RecruitingNCT07090577

Chungnam National University Hospital15 enrolled

Overview

The goal of this observational study is to identify further pathophysiologic mechanism of secondary brain injury following cardiac arrest by using serial multiomics profiling of serum and cerebrospinal fluid (CSF) samples. The main question it aims to answer is: A. The main question it aims to answer is: What are the dynamic molecular changes in serum and CSF that reflect the pathophysiological mechanisms of secondary brain injury after cardiac arrest? B. What are the differences in serum and CSF multiomic signatures between varying severities of cardiac arrest, and how are these differences associated with the underlying pathophysiological mechanisms of secondary brain injury? Serum and CSF samples that have already been prospectively collected from participants and stored in the BioBank will be used for this analysis.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Cardiac Arrest (CA)Hypoxic-Ischemic Brain Injury Post-Resuscitation Syndrome

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age ≥ 18 years old * Out-of-hospital cardiac arrest (OHCA) * Patients who have received post-resuscitation care including temperature control due to unconsciousness (Glasgow Coma Score \< 8) after sustained ROSC. * Patients who consented to the placement of lumbar catheter for storing cerebrospinal fluid and blood samples in a human biobank. Exclusion Criteria: * Patients diagnosed with a central nervous system-related disease before cardiac arrest * Patients who have undergone extracorporeal circulatory membrane oxygenation therapy * Patients who died within 24 hours from post-resuscitation care

Outcomes

Primary Outcomes

Neurological outcome

Neurological outcome is evaluated using the Cerebral Performance Category (CPC) scale. The CPC score ranges from 1 to 5, where 1 indicates good cerebral performance (normal/mild disability), 2 indicates moderate cerebral disability, 3 indicates severe cerebral disability, 4 indicates coma or vegetative state, and 5 indicates brain death. Higher scores represent a worse neurological outcome.

Time frame: after 6 months from return of spontaneous circulation

Secondary Outcomes

Illness severity score of cardiac arrest (rCAST)

llness severity is assessed using the revised Post-Cardiac Arrest Syndrome for Therapeutic hypothermia (rCAST) score, which incorporates initial rhythm, blood pH, lactate levels, motor response, and arrest duration. The total score ranges from 0 to 15, with higher scores indicating greater illness severity and worse prognosis. Based on the total score, patients are categorized into three severity risk groups: low severity (0-5 points), moderate severity (6-8 points), and high severity (9-15 points), where the high-severity group reflects the worst clinical prognosis and highest risk of poor outcome.

Time frame: immediately after return of spontaneous circulation