Clinical Cohort Construction Program of Peking University Third Hospital

For patients with cardiac arrest, brain injury is the leading cause of mortality and disability, followed by cardiac dysfunction and microcirculatory disorders. Therefore, post-resuscitation cerebral protection, myocardial protection, and the prevention and treatment of microcirculatory failure are key to the management of post-cardiac arrest syndrome (PCAS). This cohort study aims to observe exposure factors related to the cardiopulmonary resuscitation (CPR) process and the subsequent treatment of post-resuscitation syndrome, in order to explore the factors contributing to the low quality of CPR in China and to provide evidence for improving prehospital emergency care. Simultaneously, it aims to investigate exposure factors during in-hospital treatment and to identify effective interventions for improving brain function, cardiac function, and microcirculatory dysfunction.

③ Prognostic factor exploration and prognostic model establishment (may be broken down into multiple sub-questions).

For patients with cardiac arrest, neurological assessment, i.e., the evaluation of the severity of brain injury, represents both a major challenge and a key priority in the field of CPR, and it remains a current research hotspot. Accurate neurological assessment can prevent premature withdrawal of life-sustaining therapy in patients with potential for cerebral recovery-early withdrawal being a primary cause of death in cardiac arrest patients in the ICU. Conversely, it also enables early identification of patients without hope of neurological recovery, thereby providing families with more accurate prognostic information, facilitating shared decision-making regarding subsequent treatment, and reasonably optimizing the utilization of medical resources. The objective of this cohort is to establish a predictive model for mortality and poor neurological outcomes in patients with cardiac arrest, based on multimodal data incorporating clinical assessments, imaging, neuroelectrophysiology, and biomarkers.

Inclusion criteria

• Patients who have achieved return of spontaneous circulation (ROSC) after cardiac arrest;
• With accessible intravenous or intraosseous vascular access;
• Clinical manifestations meeting any one of the following criteria: presenting with post-resuscitation brain injury, post-resuscitation cardiac dysfunction, manifestations of systemic ischemia-reperfusion injury, or other ongoing deteriorating pathological changes.

Exclusion criteria

• Patients who have not achieved return of spontaneous circulation (ROSC) after cardiac arrest;
• Patients who have declined cardiopulmonary resuscitation (CPR) (or whose legally authorized representative has refused CPR).