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Critical Care Management after Cardiac Arrest

Friberg, Hans LU and Cronberg, Tobias LU (2016) In Seminars in Neurology 36(6). p.542-549
Abstract

Sudden cardiac arrest is a devastating event with high mortality and substantial morbidity among survivors. Early recognition and intervention to restore circulation is the primary goal; once that is achieved, the path toward a meaningful recovery starts. Initial in-hospital care is focused on emergency cardiac care, but soon there is a change to a more brain-oriented critical care including targeted temperature management, brain monitoring, sedation, and repeated neurologic assessments. In patients who show early signs of awakening from coma once sedation has been stopped, the prognosis is generally good. In patients with early seizures and prolonged coma after sedation has been weaned, the prognosis is often poor. A structured model... (More)

Sudden cardiac arrest is a devastating event with high mortality and substantial morbidity among survivors. Early recognition and intervention to restore circulation is the primary goal; once that is achieved, the path toward a meaningful recovery starts. Initial in-hospital care is focused on emergency cardiac care, but soon there is a change to a more brain-oriented critical care including targeted temperature management, brain monitoring, sedation, and repeated neurologic assessments. In patients who show early signs of awakening from coma once sedation has been stopped, the prognosis is generally good. In patients with early seizures and prolonged coma after sedation has been weaned, the prognosis is often poor. A structured model for neuroprognostication using several prognostication tools such as imaging, neurophysiology, biomarkers, and above all repeated clinical investigations is fundamental for the ability to properly assess the comatose cardiac arrest patient and to enable accurate and trustworthy decisions on level of care. The authors present a model for critical care management after cardiac arrest and a neuroprognostication algorithm, both in use at their institution.

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Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
brain injury, cardiac arrest, critical care, neuroprognostication, temperature management
in
Seminars in Neurology
volume
36
issue
6
pages
8 pages
publisher
Georg Thieme Verlag
external identifiers
  • scopus:85000444248
  • wos:000389282100009
ISSN
0271-8235
DOI
10.1055/s-0036-1592168
language
English
LU publication?
yes
id
370fa6e3-3fb2-41dc-b055-1448b0f45b13
date added to LUP
2016-12-16 12:36:56
date last changed
2017-09-18 11:31:37
@article{370fa6e3-3fb2-41dc-b055-1448b0f45b13,
  abstract     = {<p>Sudden cardiac arrest is a devastating event with high mortality and substantial morbidity among survivors. Early recognition and intervention to restore circulation is the primary goal; once that is achieved, the path toward a meaningful recovery starts. Initial in-hospital care is focused on emergency cardiac care, but soon there is a change to a more brain-oriented critical care including targeted temperature management, brain monitoring, sedation, and repeated neurologic assessments. In patients who show early signs of awakening from coma once sedation has been stopped, the prognosis is generally good. In patients with early seizures and prolonged coma after sedation has been weaned, the prognosis is often poor. A structured model for neuroprognostication using several prognostication tools such as imaging, neurophysiology, biomarkers, and above all repeated clinical investigations is fundamental for the ability to properly assess the comatose cardiac arrest patient and to enable accurate and trustworthy decisions on level of care. The authors present a model for critical care management after cardiac arrest and a neuroprognostication algorithm, both in use at their institution.</p>},
  author       = {Friberg, Hans and Cronberg, Tobias},
  issn         = {0271-8235},
  keyword      = {brain injury,cardiac arrest,critical care,neuroprognostication,temperature management},
  language     = {eng},
  month        = {12},
  number       = {6},
  pages        = {542--549},
  publisher    = {Georg Thieme Verlag},
  series       = {Seminars in Neurology},
  title        = {Critical Care Management after Cardiac Arrest},
  url          = {http://dx.doi.org/10.1055/s-0036-1592168},
  volume       = {36},
  year         = {2016},
}