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Bedömning av neurologisk prognos efter hjärtstopp : Uppdaterade rekommendationer från Svenska HLR-rådets expertgrupp

Rylander, Christian; Friberg, Hans LU ; Larsson, Elna Marie LU ; Liedholm, Lars Johan; Rubertsson, Sten and Cronberg, Tobias LU (2017) In Lakartidningen 114(23-24).
Abstract

European Resuscitation Council (ERC) issued updated guidelines for postresuscitation care in 2015. This paper provides updated Swedish recommendations for neurological prognostication of patients remaining unconscious after cardiac arrest (CA). The prognostication should be based on independent methods; clinical and neurophysiological examinations, imaging and biomarkers. It should not be performed earlier than three days after CA and any influence from sedatives must be negligible. Bilateral absence of both corneal and pupillary reflexes and bilaterally absent Somatosensory Evoked N20 Potentials (SSEP) at 72 hours are reliable predictors of poor outcome but the ocular reflexes have limited sensitivity and SSEP has limited availability.... (More)

European Resuscitation Council (ERC) issued updated guidelines for postresuscitation care in 2015. This paper provides updated Swedish recommendations for neurological prognostication of patients remaining unconscious after cardiac arrest (CA). The prognostication should be based on independent methods; clinical and neurophysiological examinations, imaging and biomarkers. It should not be performed earlier than three days after CA and any influence from sedatives must be negligible. Bilateral absence of both corneal and pupillary reflexes and bilaterally absent Somatosensory Evoked N20 Potentials (SSEP) at 72 hours are reliable predictors of poor outcome but the ocular reflexes have limited sensitivity and SSEP has limited availability. Hence, further delay of at least 24 hours and combinations of findings from multiple methods are often needed for reliable prognostication. If firm evidence of a poor prognosis is lacking four days after CA, further expectation with repeated examinations is recommended.

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author
organization
alternative title
Assessment of neurologic prognosis after cardiac arrest. Updated recommendations from the Swedish CPR Council Expert Group
publishing date
type
Contribution to journal
publication status
published
subject
in
Lakartidningen
volume
114
issue
23-24
publisher
Sveriges Läkarförbund
external identifiers
  • scopus:85020395360
ISSN
0023-7205
language
Swedish
LU publication?
yes
id
26e205b9-e618-4f5f-aac2-ae0307dad325
date added to LUP
2017-08-21 15:23:06
date last changed
2017-08-21 15:31:25
@misc{26e205b9-e618-4f5f-aac2-ae0307dad325,
  abstract     = {<p>European Resuscitation Council (ERC) issued updated guidelines for postresuscitation care in 2015. This paper provides updated Swedish recommendations for neurological prognostication of patients remaining unconscious after cardiac arrest (CA). The prognostication should be based on independent methods; clinical and neurophysiological examinations, imaging and biomarkers. It should not be performed earlier than three days after CA and any influence from sedatives must be negligible. Bilateral absence of both corneal and pupillary reflexes and bilaterally absent Somatosensory Evoked N20 Potentials (SSEP) at 72 hours are reliable predictors of poor outcome but the ocular reflexes have limited sensitivity and SSEP has limited availability. Hence, further delay of at least 24 hours and combinations of findings from multiple methods are often needed for reliable prognostication. If firm evidence of a poor prognosis is lacking four days after CA, further expectation with repeated examinations is recommended.</p>},
  author       = {Rylander, Christian and Friberg, Hans and Larsson, Elna Marie and Liedholm, Lars Johan and Rubertsson, Sten and Cronberg, Tobias},
  issn         = {0023-7205},
  language     = {swe},
  month        = {06},
  number       = {23-24},
  publisher    = {Sveriges Läkarförbund},
  series       = {Lakartidningen},
  title        = {Bedömning av neurologisk prognos efter hjärtstopp : Uppdaterade rekommendationer från Svenska HLR-rådets expertgrupp},
  volume       = {114},
  year         = {2017},
}