Prognosis of Cardiac Arrest—Peri-arrest and Post-arrest Considerations - 29/06/23

Doi : 10.1016/j.emc.2023.03.008

Brian D. Sumner, MD ^a,^⁎ , Christopher W. Hahn, MD ^b
^a Institute for Critical Care Medicine, 1468 Madison Avenue, Guggenheim Pavilion 6 East Room 378, New York, NY 10029, USA
^b Department of Emergency Medicine, Mount Sinai Morningside-West, 1000 10th Avenue, New York, NY 10019, USA

^∗Corresponding author.

Résumé

There has been only a small improvement in survival and neurologic outcomes in patients with cardiac arrest in recent decades. Type of arrest, length of total arrest time, and location of arrest alter the trajectory of survival and neurologic outcome. In the post-arrest phase, clinical markers such as blood markers, pupillary light response, corneal reflex, myoclonic jerking, somatosensory evoked potential, and electroencephalography testing can be used to help guide neurological prognostication. Most of the testing should be performed 72 hours post-arrest with special considerations for longer observation periods in patients who underwent TTM or who had prolonged sedation and/or neuromuscular blockade.

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Keywords : Cardiac arrest, Neuroprognostication, Neuron-specific enolase (NSE), Somatosensory evoked potentials (SSEP), Brainstem reflexes, Postcardiac arrest