Quantitative pupillometry and transcranial Doppler measurements in patients treated with hypothermia after cardiac arrest.

Abstract Background Predicting outcome after cardiac arrest (CA) is particularly difficult when therapeutic hypothermia (TH) is used. We investigated the performance of quantitative pupillometry and transcranial Doppler (TCD) in this context. Methods This prospective observational study included 82 post-CA patients. Quantitative assessment of pupillary light reflex (PLR) and TCD measurements of the two middle cerebral arteries were performed at admission (day 1) and after 24 h (day 2) during TH (33–35 °C) and sedation. Neurological outcome was assessed at 3 months using cerebral performance category (CPC) scores; patients were classified as having good (CPC 1–2) or poor (CPC 3–5) outcome. Prognostic performance was analyzed using area under the receiver operating characteristic curve (AUC-ROC). Results Patients with good outcome ( n  = 27) had higher PLR amplitude than patients with poor outcome ( n  = 55) both at day 1, 13% (10–18) (median, 25th–75th percentile) vs. 8% (2–11) ( P P Conclusion PLR measurements might be informative in the prediction of outcome of post-CA patients even under sedation and hypothermia.