Publications by authors named "Martin Kenda"
Background: Magnetic resonance imaging (MRI) is recommended by guidelines to evaluate the severity of brain ischemia after cardiac arrest for functional outcome prediction. However, standardized assessment criteria are lacking. We have developed a semi-quantitative Cardiac Arrest Brain Ischemia (CABI) score to assess the extension of brain ischemia on MRI.
View Article and Find Full Text PDFIntroduction: A grey-white matter ratio (GWR) < 1.10 at the basal ganglia level on head computed tomography (CT) previously predicted poor outcome with high specificity and moderate sensitivity in cardiac arrest patients. Data on GWR in reference populations are lacking.
View Article and Find Full Text PDFIntroduction: Qualitative assessment of hypoxic ischaemic encephalopathy on computed tomography (CT) after cardiac arrest is limited by interrater agreement. We explored how qualitative assessment can be improved.
Methods: In-depth analysis of radiological items evaluated in a prospective sub-study within the Targeted Hypothermia versus Targeted Normothermia after out-of-hospital cardiac arrest (TTM2) trial examining unconscious patients with CT > 48 h ≤ 7 days.
Background And Purpose: Most patients remain comatose within the first days after cardiac arrest (CA) and resuscitation. Guidelines recommend multimodal neuroprognostication including neuron specific enolase (NSE) as serum biomarker. Neurofilament light-chain (NFL) may have higher prognostic accuracy earlier after cardiac arrest and a lower risk of confounders.
View Article and Find Full Text PDFArticle Synopsis
- The study aimed to use standardized and automated CT assessments to predict outcomes for patients who suffered out-of-hospital cardiac arrest.
- Involving 140 unconscious patients, results showed that while qualitative assessments and various gray-white-matter ratio (GWR) models achieved 100% specificity in predicting poor outcomes, sensitivity rates varied, with automated GWR proving robust.
- The research concluded that these CT assessment methods could reliably indicate poor functional outcomes, and automated GWR could enhance accessibility for medical centers handling cardiac arrest cases.
Article Synopsis
- Selective water uptake by brain cells and brain tissue swelling after cardiac arrest contribute to hypoxic-ischemic encephalopathy, with CT scans used to evaluate this condition over time.
- This study included head CT scans from 115 cardiac arrest patients to analyze regional net water uptake (NWU) and its relationship with neurological outcomes.
- Results showed that a significant NWU (>8%) in certain brain regions was linked to poor neurological outcomes, suggesting that NWU could be a valuable biomarker for patient prognosis after cardiac arrest.
Objective: To establish a deep learning model for the detection of hypoxic-ischemic encephalopathy (HIE) features on CT scans and to compare various networks to determine the best input data format.
Methods: 168 head CT scans of patients after cardiac arrest were retrospectively identified and classified into two categories: 88 (52.4%) with radiological evidence of severe HIE and 80 (47.
Aim: To evaluate neuron-specific enolase (NSE) thresholds for prediction of neurological outcome after cardiac arrest and to analyze the influence of hemolysis and confounders.
Methods: Retrospective analysis from a cardiac arrest registry. Determination of NSE serum concentration and hemolysis-index (h-index) 48-96 hours after cardiac arrest.
Article Synopsis
- Bilaterally absent cortical somatosensory evoked potentials (SSEPs) are linked to a high likelihood of poor outcomes in comatose cardiac arrest patients, with only 0.8% surviving with a good outcome.
- This study assessed the amplitudes of cortical SSEPs using a standardized method, finding significant inter-rater agreement among evaluators and identifying 42.9% of poor outcome patients with low amplitude SSEPs.
- The findings suggest that SSEPs lower than 0.5 µV indicate severe brain injury, while high amplitudes correlate with better prognosis, emphasizing the importance of standardized assessments in clinical decisions.
Background: Clinical observations indicated that vaccine-induced immune thrombosis with thrombocytopenia (VITT)-associated cerebral venous sinus thrombosis (CVST) often has a space-occupying effect and thus necessitates decompressive surgery (DS). While comparing with non-VITT CVST, this study explored whether VITT-associated CVST exhibits a more fulminant clinical course, different perioperative and intensive care unit management, and worse long-term outcome.
Methods: This multicenter, retrospective cohort study collected patient data from 12 tertiary centers to address priorly formulated hypotheses concerning the clinical course, the perioperative management with related complications, extracerebral complications, and the functional outcome (modified Rankin Scale) in patients with VITT-associated and non-VITT CVST, both with DS.
Background: Head computed tomography (CT) is used to predict neurological outcome after cardiac arrest (CA). The current reference standard includes quantitative image analysis by a neuroradiologist to determine the Gray-White-Matter Ratio (GWR) which is calculated the manual measurement of radiodensity in different brain regions. Recently, automated analysis methods have been introduced.
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- Head CT is a recommended method for predicting outcomes after cardiac arrest, but there is no standardized assessment system for diagnosing hypoxic-ischaemic encephalopathy (HIE).
- The study is part of an international trial (TTM2) aiming to evaluate CT images of patients who are still unconscious 48 hours after cardiac arrest, using a standardized protocol to assess HIE severity and related brain function.
- The outcomes will be measured through functional assessments at six months post-arrest, and findings will help establish reliable criteria for using CT in neuroprognostication after cardiac arrest.
Objectives: Prognostication of outcome is an essential step in defining therapeutic goals after cardiac arrest. Gray-white-matter ratio obtained from brain CT can predict poor outcome. However, manual placement of regions of interest is a potential source of error and interrater variability.
View Article and Find Full Text PDFImportance: Neuroprognostication studies are potentially susceptible to a self-fulfilling prophecy as investigated prognostic parameters may affect withdrawal of life-sustaining therapy.
Objective: To compare the results of prognostic parameters after cardiac arrest (CA) with the histopathologically determined severity of hypoxic-ischemic encephalopathy (HIE) obtained from autopsy results.
Design, Setting, And Participants: In a retrospective, 3-center cohort study of all patients who died following cardiac arrest during their intensive care unit stay and underwent autopsy between 2003 and 2015, postmortem brain histopathologic findings were compared with post-CA brain computed tomographic imaging, electroencephalographic (EEG) findings, somatosensory-evoked potentials, and serum neuron-specific enolase levels obtained during the intensive care unit stay.
Aim: Gray-white-matter ratio (GWR) calculated from head CT is a radiologic index of tissue changes associated with hypoxic-ischemic encephalopathy after cardiac arrest (CA). Evidence from previous studies indicates high specificity for poor outcome prediction at GWR thresholds of 1.10-1.
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