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Low cerebral blood flow after cardiac arrest is not associated with anaerobic cerebral metabolism

2017· article· en· W2745551602 on OpenAlexaff
Cornelia Hoedemaekers, Philip N. Ainslie, Stijn Hinssen, Marcel Aries, Laurens L. A. Bisschops, Jeannette Hofmeijer, Johannes G. van der Hoeven

Bibliographic record

VenueResuscitation · 2017
Typearticle
Languageen
FieldMedicine
TopicCardiac Arrest and Resuscitation
Canadian institutionsUniversity of British Columbia
Fundersnot available
KeywordsMedicineAnaerobic exerciseArterial bloodCerebral blood flowInternal medicineAnesthesiaCardiologyTranscranial DopplerCardiac outputBlood flowMiddle cerebral arteryHemodynamicsIschemiaPhysiology

Abstract

fetched live from OpenAlex

Aim of the study: Estimation of cerebral anaerobic metabolism in survivors and non-survivors after cardiac arrest. Methods: We performed an observational study in twenty comatose patients after cardiac arrest and 19 healthy control subjects. We measured mean flow velocity in the middle cerebral artery (MFV MCA ) by transcranial Doppler. Arterial and jugular blood samples were used for calculation of the jugular venous-to-arterial CO 2 /arterial to-jugular venous O 2 content difference ratio. Results: After cardiac arrest, MFV MCA increased from 26.0 [18.6-40.4] cm/sec on admission to 63.9[48.3-73.1] cm/sec after 72 h (p < 0.0001), with no significant differences between survivors and non-survivors (p = 0.4853). The MFV MCA in controls was 59.1[52.8-69.0] cm/sec. The oxygen extraction fraction (O 2 EF) was 38.9[24.4-47.7]% on admission and decreased significantly to 17.3[12.1-26.2]% at 72 h (p < 0.0001). The decrease in O 2 EF was more pronounced in non-survivors (p = 0.0173). O 2 EF in the control group was 35.4[32.4-38.7]%. The jugular bulb-arterial CO 2 to arterial-jugular bulb O 2 content difference ratio was >1 at all time points after cardiac arrest and did not change during admission, with no differences between survivors and non-survivors. Values in cardiac arrest patients were similar to those in normal subjects. Conclusions: In this study, low CBF after cardiac arrest is not associated with anaerobic metabolism. Hypoperfusion appears to be the consequence of a decrease of neuronal functioning and metabolic needs. Alternatively, hypoperfusion may decrease cerebral metabolism. Subsequently, metabolism increases in survivors, consistent with resumption of neuronal activity, whereas in non-survivors lasting low metabolism reflects irreversible neuronal damage.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.080
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0010.000
Scholarly communication0.0000.001
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.011
GPT teacher head0.251
Teacher spread0.240 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations38
Published2017
Admission routes1
Has abstractyes

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