Takeaway
People who undergo targeted temperature management after cardiac arrest, are less likely to recover from a coma if they have brain magnetic resonance spectroscopy-determined decreases in total N-acetyl-aspartate and increased lactate production.
Why this matters
Although magnetic resonance spectroscopy can guide prognosis, there are few data on the spectrum of changes observed in brain-specific metabolic markers in adults undergoing targeted temperature management following a cardiac arrest.
This unique study reveals that differences in several magnetic resonance spectroscopy detectable metabolites are linked to likelihood of coma recovery. The findings suggest that while some neuronal injury is tolerated, impaired aerobic oxidative metabolism represents severe, potentially irreversible hypoxic-ischemic encephalopathy.