• Matthew P Kirschen, Natalie L Ullman, Ron W Reeder, Tageldin Ahmed, Michael J Bell, Robert A Berg, Candice Burns, Joseph A Carcillo, Todd C Carpenter, Wesley DiddleJJDepartment of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia University of Pennsylvania Philadelphia PA USA., Myke Federman, Ericka L Fink, Aisha H Frazier, Stuart H Friess, Kathryn Graham, Christopher M Horvat, Leanna L Huard, Todd J Kilbaugh, Tensing Maa, Arushi Manga, Patrick S McQuillen, Kathleen L Meert, Ryan W Morgan, Peter M Mourani, Vinay M Nadkarni, Maryam Y Naim, Daniel Notterman, Chella A Palmer, Murray M Pollack, Anil Sapru, Matthew P Sharron, Neeraj Srivastava, Bradley Tilford, Shirley Viteri, Heather A Wolfe, Andrew R Yates, Alexis Topjian, Robert M Sutton, and Craig A Press.
• Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia University of Pennsylvania Philadelphia PA USA; Division of Neurology, Department of Pediatrics, The Children's Hospital of Philadelphia University of Pennsylvania Philadelphia PA USA. Electronic address: kirschenm@chop.edu.
• Resuscitation. 2025 Jan 21; 207: 110506110506.

AimsTo determine which patient and cardiac arrest factors were associated with obtaining neuroimaging after in-hospital cardiac arrest, and among those patients who had neuroimaging, factors associated with which neuroimaging modality was obtained.MethodsRetrospective cohort study of patients who survived in-hospital cardiac arrest (IHCA) and were enrolled in the ICU-RESUS trial (NCT02837497).ResultsWe tabulated ultrasound (US), CT, and MRI frequency within 7 days following IHCA and identified patient and cardiac arrest factors associated with neuroimaging modalities utilized. Multivariable models determined which factors were associated with obtaining neuroimaging. Of 1000 patients, 44% had ≥ 1 neuroimaging study (US in 31%, CT in 18%, and MRI in 6% of patients). Initial USs were performed a median of 0.3 [0.1,0.5], CTs 1.4 [0.4,2.8], and MRIs 4.1 [2.2,5.1] days post-arrest. Neuroimaging timing and frequency varied by site. Factors associated with greater odds of neuroimaging were cardiac arrest in CICU (versus PICU), longer duration CPR, receiving ECMO post-arrest, and post-arrest care with targeted temperature management or EEG monitoring. US performance was associated with congenital heart disease. CT was associated with age ≥ 1-month, greater pre-arrest disability, and receiving CPR for ≥ 16 min. MRI utilization increased with pre-existing respiratory insufficiency and respiratory decompensation as arrest cause, and medical cardiac and surgical non-cardiac or trauma illness category. Overall, if neuroimaging was obtained, US was more common in CICU while CT/MRI were utilized more in PICU.ConclusionsPractice patterns for acquiring neuroimaging after IHCA are variable and influenced by patient, cardiac arrest, and site factors.Copyright © 2025 Elsevier B.V. All rights reserved.

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