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How to assess prognosis after cardiac arrest and therapeutic hypothermia

Taccone, Fabio Silvio; Cronberg, Tobias LU ; Friberg, Hans LU ; Greer, David; Horn, Janneke; Oddo, Mauro; Scolletta, Sabino and Vincent, Jean-Louis (2014) In Critical Care 18(1).
Abstract
The prognosis of patients who are admitted in a comatose state following successful resuscitation after cardiac arrest remains uncertain. Although the introduction of therapeutic hypothermia (TH) and improvements in post-resuscitation care have significantly increased the number of patients who are discharged home with minimal brain damage, short-term assessment of neurological outcome remains a challenge. The need for early and accurate prognostic predictors is crucial, especially since sedation and TH may alter the neurological examination and delay the recovery of motor response for several days. The development of additional tools, including electrophysiological examinations (electroencephalography and somatosensory evoked potentials),... (More)
The prognosis of patients who are admitted in a comatose state following successful resuscitation after cardiac arrest remains uncertain. Although the introduction of therapeutic hypothermia (TH) and improvements in post-resuscitation care have significantly increased the number of patients who are discharged home with minimal brain damage, short-term assessment of neurological outcome remains a challenge. The need for early and accurate prognostic predictors is crucial, especially since sedation and TH may alter the neurological examination and delay the recovery of motor response for several days. The development of additional tools, including electrophysiological examinations (electroencephalography and somatosensory evoked potentials), neuroimaging and chemical biomarkers, may help to evaluate the extent of brain injury in these patients. Given the extensive literature existing on this topic and the confounding effects of TH on the strength of these tools in outcome prognostication after cardiac arrest, the aim of this narrative review is to provide a practical approach to post-anoxic brain injury when TH is used. We also discuss when and how these tools could be combined with the neurological examination in a multimodal approach to improve outcome prediction in this population. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Critical Care
volume
18
issue
1
publisher
BioMed Central
external identifiers
  • wos:000338991900016
  • scopus:84892411789
ISSN
1364-8535
DOI
10.1186/cc13696
language
English
LU publication?
yes
id
742692d3-2da4-4bfe-a292-bf6b9c2280a5 (old id 4598825)
date added to LUP
2014-09-05 11:28:21
date last changed
2017-10-22 03:32:27
@article{742692d3-2da4-4bfe-a292-bf6b9c2280a5,
  abstract     = {The prognosis of patients who are admitted in a comatose state following successful resuscitation after cardiac arrest remains uncertain. Although the introduction of therapeutic hypothermia (TH) and improvements in post-resuscitation care have significantly increased the number of patients who are discharged home with minimal brain damage, short-term assessment of neurological outcome remains a challenge. The need for early and accurate prognostic predictors is crucial, especially since sedation and TH may alter the neurological examination and delay the recovery of motor response for several days. The development of additional tools, including electrophysiological examinations (electroencephalography and somatosensory evoked potentials), neuroimaging and chemical biomarkers, may help to evaluate the extent of brain injury in these patients. Given the extensive literature existing on this topic and the confounding effects of TH on the strength of these tools in outcome prognostication after cardiac arrest, the aim of this narrative review is to provide a practical approach to post-anoxic brain injury when TH is used. We also discuss when and how these tools could be combined with the neurological examination in a multimodal approach to improve outcome prediction in this population.},
  articleno    = {202},
  author       = {Taccone, Fabio Silvio and Cronberg, Tobias and Friberg, Hans and Greer, David and Horn, Janneke and Oddo, Mauro and Scolletta, Sabino and Vincent, Jean-Louis},
  issn         = {1364-8535},
  language     = {eng},
  number       = {1},
  publisher    = {BioMed Central},
  series       = {Critical Care},
  title        = {How to assess prognosis after cardiac arrest and therapeutic hypothermia},
  url          = {http://dx.doi.org/10.1186/cc13696},
  volume       = {18},
  year         = {2014},
}