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BRAIN-1 (Brain Resuscitation Advancement International Network)

The BRAIN-1 (Brain Resuscitation Advancement International Network - 1) is an international prospective study aimed at examining the underlying physiologic mechanisms that occur during cardiac arrest. This will be attained through conducting a variety of physiologic tests, assessing neurologic and cognitive function as well as cerebral monitoring techniques.  In particular, the study will be using the INVOS® Cerebral Oximeter provided by Somanetics, an FDA-cleared noninvasive patient monitor that measures changes in oxygen levels that provide an indication of brain oxygen levels and circulation of blood to the brain. Through analyzing cerebral perfusion, we will gain additional information of cerebral function during cardiac arrest and how this impacts neurologic and cognitive outcomes of post cardiac arrest patients. This study may help to improve the medical and psychological care of patients who have undergone cardiac arrest and help clinicians develop more effective rehabilitation programs for patients. This study is one of many of the Human Consciousness Project that will help to further elucidate many unknown aspects of the human brain and consciousness.

Memories and thought processes from period of resuscitation

A number of recent studies have indicated that 10% of cardiac arrest survivors report memories and thought processes from their period of resuscitation. A small proportion of survivors have also described the ability to “see” and “hear” details of their cardiac arrest. Even though the significance and mechanisms that lead to these experiences are not fully understood, nevertheless their occurrence may have significant implications for establishing clinical markers of improved brain resuscitation, as well as long term psychological support of cardiac arrest survivors.

The occurrence of cognitive function during cardiac arrest also raises the possibility that patients may have received improved “cerebral resuscitation” leading to consciousness and the activity of the mind. Furthermore, the occurrence of such experiences in cardiac arrest survivors has also been shown to lead to long-term positive life enhancing effects.

Through a variety of psychological and physiological tests as well as cerebral monitoring techniques, we aim to conduct the first comprehensive study examining the relationship between the human mind, consciousness and brain during cardiac arrest. Specifically, we aim to study the relationship between consciousness and the quality of cerebral resuscitation (as measured through non-invasive monitoring of cerebral perfusion) and its outcome on neurological, emotional and cognitive morbidity. Patients’ experiences and cognition will also be examined qualitatively immediately after their cardiac arrest as well as at regular intervals for a period of two years. The tests of consciousness include the use of independent markers designed to objectively examine the validity of survivor’s claims of being able to “see” and “hear” during cardiac arrest as well as their underlying association with socio-cultural and cognitive parameters. We will also examine the relationship between cognitive function during cardiac arrest with clinical and physiological markers, the severity of cardiac arrest, as well as markers of the relative effectiveness of resuscitation. An understanding of the nature of human consciousness and mental processes during cardiac arrest and its relationship with brain perfusion may have significant implications for improving the acute management of cardiac arrest resuscitation as well as the long term psychological care of survivors.

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