Continuous evaluation of neurological prognosis after cardiac arrest.
(2012) In Acta Anaesthesiologica Scandinavica- Abstract
- Post-resuscitation care has changed in the last decade, and outcome after cardiac arrest has improved, thanks to several combined measures. Induced hypothermia has shown a treatment benefit in two randomized trials, but some doubts remain. General care has improved, including the use of emergency coronary intervention. Assessment of neurological function and prognosis in comatose cardiac arrest patient is challenging, especially when treated with hypothermia. In this review, we evaluate the recent literature and discuss the available evidence for prognostication after cardiac arrest in the era of temperature management. Relevant literature was identified searching PubMed and reading published papers in the field, but no standardized search... (More)
- Post-resuscitation care has changed in the last decade, and outcome after cardiac arrest has improved, thanks to several combined measures. Induced hypothermia has shown a treatment benefit in two randomized trials, but some doubts remain. General care has improved, including the use of emergency coronary intervention. Assessment of neurological function and prognosis in comatose cardiac arrest patient is challenging, especially when treated with hypothermia. In this review, we evaluate the recent literature and discuss the available evidence for prognostication after cardiac arrest in the era of temperature management. Relevant literature was identified searching PubMed and reading published papers in the field, but no standardized search strategy was used. The complexity of predicting outcome after cardiac arrest and induced hypothermia is recognized in the literature, and no single test can predict a poor prognosis with absolute certainty. A clinical neurological examination is still the gold standard, but the results need careful interpretation because many patients are affected by sedatives and by hypothermia. Common adjuncts include neurophysiology, brain imaging and biomarkers, and a multimodal strategy is generally recommended. Current guidelines for prediction of outcome after cardiac arrest and induced hypothermia are not sufficient. Based on our expert opinion, we suggest a multimodal approach with a continuous evaluation of prognosis based on repeated neurological examinations and electroencephalography. Somatosensory-evoked potential is an established method to help determine a poor outcome and is recommended, whereas biomarkers and magnetic resonance imaging are promising adjuncts. We recommend that a decisive evaluation of prognosis is performed at 72 h after normothermia or later in a patient free of sedative and analgetic drugs. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/2966594
- author
- Friberg, Hans LU ; Rundgren, Malin LU ; Westhall, Erik LU ; Nielsen, Niklas LU and Cronberg, Tobias LU
- organization
- publishing date
- 2012-07-26
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Acta Anaesthesiologica Scandinavica
- publisher
- Wiley-Blackwell
- external identifiers
-
- wos:000312271800003
- pmid:22834632
- scopus:84870982770
- ISSN
- 0001-5172
- DOI
- 10.1111/j.1399-6576.2012.02736.x
- language
- English
- LU publication?
- yes
- id
- f3a567f9-e616-4d48-94e7-5c0f7468234d (old id 2966594)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/22834632?dopt=Abstract
- date added to LUP
- 2016-04-04 07:59:53
- date last changed
- 2022-01-29 02:54:28
@article{f3a567f9-e616-4d48-94e7-5c0f7468234d,
abstract = {{Post-resuscitation care has changed in the last decade, and outcome after cardiac arrest has improved, thanks to several combined measures. Induced hypothermia has shown a treatment benefit in two randomized trials, but some doubts remain. General care has improved, including the use of emergency coronary intervention. Assessment of neurological function and prognosis in comatose cardiac arrest patient is challenging, especially when treated with hypothermia. In this review, we evaluate the recent literature and discuss the available evidence for prognostication after cardiac arrest in the era of temperature management. Relevant literature was identified searching PubMed and reading published papers in the field, but no standardized search strategy was used. The complexity of predicting outcome after cardiac arrest and induced hypothermia is recognized in the literature, and no single test can predict a poor prognosis with absolute certainty. A clinical neurological examination is still the gold standard, but the results need careful interpretation because many patients are affected by sedatives and by hypothermia. Common adjuncts include neurophysiology, brain imaging and biomarkers, and a multimodal strategy is generally recommended. Current guidelines for prediction of outcome after cardiac arrest and induced hypothermia are not sufficient. Based on our expert opinion, we suggest a multimodal approach with a continuous evaluation of prognosis based on repeated neurological examinations and electroencephalography. Somatosensory-evoked potential is an established method to help determine a poor outcome and is recommended, whereas biomarkers and magnetic resonance imaging are promising adjuncts. We recommend that a decisive evaluation of prognosis is performed at 72 h after normothermia or later in a patient free of sedative and analgetic drugs.}},
author = {{Friberg, Hans and Rundgren, Malin and Westhall, Erik and Nielsen, Niklas and Cronberg, Tobias}},
issn = {{0001-5172}},
language = {{eng}},
month = {{07}},
publisher = {{Wiley-Blackwell}},
series = {{Acta Anaesthesiologica Scandinavica}},
title = {{Continuous evaluation of neurological prognosis after cardiac arrest.}},
url = {{http://dx.doi.org/10.1111/j.1399-6576.2012.02736.x}},
doi = {{10.1111/j.1399-6576.2012.02736.x}},
year = {{2012}},
}