4.3 Article

Brain Resuscitation and Prognosis After Cardiac Arrest

Journal

CRITICAL CARE CLINICS
Volume 30, Issue 4, Pages 765-+

Publisher

W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.ccc.2014.06.007

Keywords

Cardiac arrest; Hypoxic-ischemic encephalopathy; Induced hypothermia; Prognostication; Coma

Funding

  1. NIH COBRE [1P30GM103341-01]
  2. Hawaii Community Foundation [11ADVC-49231]
  3. Queen Emma Research Fund

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Brain injury represents the major cause of long-term disability and mortality among patients resuscitated from cardiac arrest. Brain-directed therapies include maintenance of normal oxygenation, hemodynamic support to optimize cerebral perfusion, glycemic control, and targeted temperature management. Pertinent guidelines and recommendations are reviewed for brain-directed treatment. The latest clinical trial data regarding targeted temperature management are also reviewed. Contemporary prognostication among initially comatose cardiac arrest survivors uses a combination of clinical and electrophysiologic tests. The most recent guidelines for prognostication after cardiac arrest are reviewed. Ongoing research regarding the effects of induced hypothermia on prognostic algorithms is also reviewed.

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