TCD Post-Resuscitation Blood Flow & Edema Monitor

DESCRIPTION (provided by applicant): The aim of this project is to contribute a tool towards accomplishing improved outcomes following cardiopulmonary resuscitation (CPR). It is submitted in response to NIH program announcement PA-04-059. This proposal is to prototype an integrated Doppler ultrasound device to monitor brain blood flow and brain tissue motions in the post-resuscitation period following cardiac arrest. The technology proposed here promises high value for two considerations: (1) basic discovery of information for avoiding reperfusion injury in the post-resuscitation patient, and (2) development of a post-resuscitation monitor for commercial application, to reduce incidence of adverse outcomes currently experienced in the first thirty days following resuscitation. Power M-mode Doppler comprises the heart of this platform and is capable of monitoring four major vessels-the middle and anterior cerebral arteries, bilaterally-supplying 80% of the total blood flow to the brain, as well as perfusion related motions in the parenchyma in proximity to these vessels. The innovative core of this proposal is to combine in this platform the ability to acquire and store the following information for each of the monitored vessels in the post-resuscitation patient: blood velocity, relative blood volume flow, tissue motion dynamics (edema), and embolization. Instrument performance will be tested by phantom and then will be used to explore post-resuscitation physiology in an animal model of cardiac arrest. Our central hypothesis is that the Doppler ultrasound instrument we will construct will detect signals that correlate with known parameters indicating severity of injury in the post resuscitation period following cardiac arrest. Further, we anticipate this device will be more sensitive to the early stages of reperfusion injury that lead to acute adverse outcomes.