Brain injury after cardiac arrest : from prognostication of comatose patients to rehabilitation
(2020) In The Lancet Neurology 19(7). p.611-622- Abstract
More patients are surviving cardiac arrest than ever before; however, the burden now lies with estimating neurological prognoses in a large number of patients who were initially comatose, in whom the ultimate outcome is unclear. Neurologists, neurointensivists, and clinical neurophysiologists must accurately balance the concern that overly conservative prognostication could leave patients in a severely disabled state, with the possibility that inaccurately pessimistic prognostication could lead to the withdrawal of life-sustaining treatment in patients who might otherwise have a good functional outcome. Prognostic tools have improved greatly, including electrophysiological tests, neuroimaging, and chemical biomarkers. Conclusions about... (More)
More patients are surviving cardiac arrest than ever before; however, the burden now lies with estimating neurological prognoses in a large number of patients who were initially comatose, in whom the ultimate outcome is unclear. Neurologists, neurointensivists, and clinical neurophysiologists must accurately balance the concern that overly conservative prognostication could leave patients in a severely disabled state, with the possibility that inaccurately pessimistic prognostication could lead to the withdrawal of life-sustaining treatment in patients who might otherwise have a good functional outcome. Prognostic tools have improved greatly, including electrophysiological tests, neuroimaging, and chemical biomarkers. Conclusions about the prognosis should be delayed at least 72 h after arrest to allow for the clearance of sedative drugs. Cognitive impairments, emotional problems, and fatigue are common among patients who have survived cardiac arrest, and often go unrecognised despite being related to caregiver burden and a decreased participation in society. Through simple screening, these problems can be identified, and patients can be provided with adequate information and rehabilitation.
(Less)
- author
- Cronberg, Tobias LU ; Greer, David M. ; Lilja, Gisela LU ; Moulaert, Véronique ; Swindell, Paul and Rossetti, Andrea O.
- organization
- publishing date
- 2020
- type
- Contribution to journal
- publication status
- published
- subject
- in
- The Lancet Neurology
- volume
- 19
- issue
- 7
- pages
- 12 pages
- publisher
- Lancet Publishing Group
- external identifiers
-
- scopus:85086455108
- pmid:32562686
- ISSN
- 1474-4422
- DOI
- 10.1016/S1474-4422(20)30117-4
- language
- English
- LU publication?
- yes
- id
- a93da4af-8cd4-4930-8a50-04037161357b
- date added to LUP
- 2020-07-02 11:39:31
- date last changed
- 2024-06-13 19:04:54
@article{a93da4af-8cd4-4930-8a50-04037161357b,
abstract = {{<p>More patients are surviving cardiac arrest than ever before; however, the burden now lies with estimating neurological prognoses in a large number of patients who were initially comatose, in whom the ultimate outcome is unclear. Neurologists, neurointensivists, and clinical neurophysiologists must accurately balance the concern that overly conservative prognostication could leave patients in a severely disabled state, with the possibility that inaccurately pessimistic prognostication could lead to the withdrawal of life-sustaining treatment in patients who might otherwise have a good functional outcome. Prognostic tools have improved greatly, including electrophysiological tests, neuroimaging, and chemical biomarkers. Conclusions about the prognosis should be delayed at least 72 h after arrest to allow for the clearance of sedative drugs. Cognitive impairments, emotional problems, and fatigue are common among patients who have survived cardiac arrest, and often go unrecognised despite being related to caregiver burden and a decreased participation in society. Through simple screening, these problems can be identified, and patients can be provided with adequate information and rehabilitation.</p>}},
author = {{Cronberg, Tobias and Greer, David M. and Lilja, Gisela and Moulaert, Véronique and Swindell, Paul and Rossetti, Andrea O.}},
issn = {{1474-4422}},
language = {{eng}},
number = {{7}},
pages = {{611--622}},
publisher = {{Lancet Publishing Group}},
series = {{The Lancet Neurology}},
title = {{Brain injury after cardiac arrest : from prognostication of comatose patients to rehabilitation}},
url = {{http://dx.doi.org/10.1016/S1474-4422(20)30117-4}},
doi = {{10.1016/S1474-4422(20)30117-4}},
volume = {{19}},
year = {{2020}},
}