# Cerebral autoregulation and MRI measures of brain injury after pediatric-post cardiac arrest

> **NIH NIH K23** · CHILDREN'S HOSP OF PHILADELPHIA · 2022 · $178,949

## Abstract

PROJECT ABSTRACT
 Pediatric cardiac arrest is common, with resultant high morbidity and mortality. Neurologic disability
occurs in up to 80% of children who survive a cardiac arrest. Brain injury after cardiac arrest is caused by the
initial hypoxic-ischemic event and from secondary brain injury that occurs in the following hours to days. The
focus of post-cardiac arrest care is to reduce secondary brain injury. Cerebral autoregulation (CAR) is a
physiologic process by which cerebral blood vessels dilate or constrict to maintain relatively constant cerebral
blood flow (CBF) across a range of mean arterial blood pressures (MAPs). Impaired CAR makes the brain
vulnerable to states of hypoperfusion and hyperperfusion which can contribute to secondary brain injury and
preventable neurologic disability. There is a knowledge gap regarding the MAP at which CAR is most intact
after pediatric cardiac arrest, and the impact of the deviation from this optimal MAP on brain injury and clinical
outcomes. The central hypothesis of this proposal is that patients with larger differences between their MAP
and optimal MAP after cardiac arrest will have worse microstructural brain injury and clinical outcomes.
 For this proposal, CBF will be measured directly using an advanced, non-invasive optical imaging
technique called diffuse correlation spectroscopy (DCS), which will be used to calculate optimal MAP. Brain
injury will be quantified using diffusion magnetic resonance imaging (MRI). The primary clinical outcome is
neurologic disability at hospital discharge based on the Pediatric Cerebral Performance Category. The
objectives of the proposed research are to determine whether patients with larger deviations from their DCS-
determined optimal MAP have worse clinical outcomes (Aim 1) and microstructural brain injury on diffusion
MRI (Aim 2) compared to patients with smaller deviations from their optimal MAP. In addition, regional CBF
derived from DCS will be correlated with CBF derived from arterial spin labeled (ASL) MRI (Aim 3).
 The successful completion of these studies will further our understanding of the mechanisms underlying
post-cardiac arrest brain injury and inform future trials of cerebral physiology-targeted management strategies
to improve pediatric cardiac arrest outcomes. The applicant, Dr. Matthew Kirschen, a pediatric intensivist and
neurologist at the Children’s Hospital of Philadelphia and University of Pennsylvania, will engage in a rigorous
training program of didactic courses and mentoring by experts in pediatric cardiac arrest, cerebral physiology
and autoregulation, and brain imaging. He will gain expertise in clinical biostatistics through the Master of
Science in Clinical Epidemiology program, advanced optical imaging, and diffusion MRI analytics. Through the
proposed studies, his parallel career development plan, a team of dedicated and experienced mentors, and a
world-class environment, Dr. Kirschen will achieve his goal of becoming an in...

## Key facts

- **NIH application ID:** 10487553
- **Project number:** 5K23NS116120-02
- **Recipient organization:** CHILDREN'S HOSP OF PHILADELPHIA
- **Principal Investigator:** Matthew P Kirschen
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $178,949
- **Award type:** 5
- **Project period:** 2021-09-15 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10487553

## Citation

> US National Institutes of Health, RePORTER application 10487553, Cerebral autoregulation and MRI measures of brain injury after pediatric-post cardiac arrest (5K23NS116120-02). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10487553. Licensed CC0.

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