Quantitative Pupillometry Obtained During Cardiac Arrest: A Case Report

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INTRODUCTION: Quantitative pupillometry is increasingly used to assess patients' neurologic function quickly and accurately. This case report discusses the feasibility of collecting quantitative pupillometry data for patients experiencing cardiac arrest, the potential value of these data, and limitations of quantitative pupillometry. CLINICAL FINDINGS: An 83-year-old woman was admitted to the cardiac catheterization laboratory for coronary angiography and percutaneous coronary intervention. She experienced cardiac arrest during the procedure, and the rapid response team was deployed. DIAGNOSIS: Coronary artery disease with angina was present upon admission. The patient was admitted with the intent to perform percutaneous coronary intervention of the left anterior descending coronary artery. INTERVENTIONS: During the cardiac arrest and while staff members were performing chest compressions, rapid response team nurses obtained quantitative pupillometry readings to assess pupil function. OUTCOMES: The quantitative pupillometry readings obtained from the left and right eyes suggested that neurologic function was abnormal but still present. The main challenges associated with performing quantitative pupillometry during a cardiac arrest are overcrowding of essential personnel at the head of bed and finding an appropriate time to obtain readings without compromising life-sustaining interventions. CONCLUSION: Using quantitative pupillometry to assess pupil function during cardiac arrest is feasible when performed by nurses. This report may facilitate pupil assessment during cardiac arrest and provide new insights into cerebral perfusion as a biomarker of recovery.

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