This study aimed to explore the changes in blood–brain barrier (BBB) permeability and intracranial pressure (ICP) for the first 24 h after the return of spontaneous circulation (ROSC) and their association with injury severity of cardiac arrest. This prospective study analysed the BBB permeability assessed using the albumin quotient (Qa) and ICP every 2 h for the first 24 h after ROSC. The injury severity of cardiac arrest was assessed using Pittsburgh Cardiac Arrest Category (PCAC) scores. The primary outcome was the time course of changes in the BBB permeability and ICP for the first 24 h after ROSC and their association with injury severity (PCAC scores of 1–4). Qa and ICP were measured 274 and 197 times, respectively, in 32 enrolled patients. Overall, the BBB permeability increased progressively over time after ROSC, and then it increased significantly at 18 h after ROSC compared with the baseline. In contrast, the ICP revealed non-significant changes for the first 24 h after ROSC. The Qa in the PCAC 2 group was < 0.01, indicating normal or mild BBB disruption at all time points, whereas the PCAC 3 and 4 groups showed a significant increase in BBB permeability at 14 and 22 h, and 12 and 14 h after ROSC, respectively. BBB permeability increased progressively over time for the first 24 h after ROSC despite post-resuscitation care, whereas ICP did not change over time. BBB permeability has an individual pattern when stratified by injury severity.

中文翻译：

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心脏骤停后缺氧缺血性脑损伤中前 24 小时的血脑屏障通透性

本研究旨在探讨自主循环（ROSC）恢复后最初24小时内血脑屏障（BBB）通透性和颅内压（ICP）的变化及其与心脏骤停损伤严重程度的关系。这项前瞻性研究分析了 ROSC 后前 24 小时内每 2 小时使用白蛋白商 (Qa) 和 ICP 评估的 BBB 通透性。使用匹兹堡心脏骤停类别（PCAC）评分评估心脏骤停的损伤严重程度。主要结果是 ROSC 后前 24 小时 BBB 通透性和 ICP 变化的时间过程及其与损伤严重程度的关系（PCAC 评分为 1-4）。32 名入组患者的 Qa 和 ICP 分别测量了 274 次和 197 次。总体而言，BBB通透性在ROSC后随着时间的推移逐渐增加，然后在ROSC后18小时与基线相比显着增加。相反，ICP 显示 ROSC 后前 24 小时内没有显着变化。PCAC 2 组的 Qa < 0.01，表明在所有时间点 BBB 均正常或轻度破坏，而 PCAC 3 和 4 组在 ROSC 后 14 和 22 小时以及 12 和 14 小时显示 BBB 通透性显着增加。分别。尽管进行了复苏后护理，但在 ROSC 后的前 24 小时内，BBB 通透性随着时间的推移逐渐增加，而 ICP 没有随着时间的推移而变化。按损伤严重程度分层时，血脑屏障渗透性具有个体模式。