Neuroprognostication in the Post Cardiac Arrest Patient: A Canadian Cardiovascular Position Statement

被引：17

作者：

Fordyce, Christopher B. ^{[1
,2
]}

Kramer, Andreas H. ^{[3
,4
]}

Ainsworth, Craig ^{[5
]}

Christenson, Jim ^{[6
]}

Hunter, Gary ^{[7
]}

Kromm, Julie ^{[3
,4
]}

Soto, Carmen Lopez ^{[8
]}

Scales, Damon C. ^{[9
]}

Sekhon, Mypinder ^{[10
]}

van Diepen, Sean ^{[11
,12
]}

Dragoi, Laura ^{[9
]}

Josephson, Colin ^{[3
,4
]}

Kutsogiannis, Jim ^{[11
]}

Le May, Michel R. ^{[13
]}

Overgaard, Christopher B. ^{[14
]}

Savard, Martin ^{[2
,15
]}

Schnell, Gregory ^{[16
]}

Wong, Graham C. ^{[1
,2
]}

Belley-Cote, Emilie ^{[5
]}

Fantaneanu, Tadeu A. ^{[17
]}

Granger, Christopher B. ^{[18
]}

Luk, Adriana ^{[19
,20
]}

Mathew, Rebecca ^{[21
,22
]}

McCredie, Victoria ^{[23
,24
]}

Murphy, Laurel ^{[25
,26
]}

Teitelbaum, Jeanne ^{[27
]}

机构：

[1] Vancouver Gen Hosp, Dept Med, Div Cardiol, Vancouver, BC, Canada

[2] Univ British Columbia, Ctr Cardiovasc Innovat, Vancouver, BC, Canada

[3] Univ Calgary, Hotchkiss Brain Inst, Dept Clin Neurosci, Calgary, AB, Canada

[4] Univ Calgary, Dept Crit Care, Calgary, AB, Canada

[5] McMaster Univ, Dept Med, Div Cardiol, Hamilton, ON, Canada

[6] Univ British Columbia, Dept Emergency Med, Vancouver, BC, Canada

[7] Univ Saskatchewan, Div Neurol, Saskatoon, SK, Canada

[8] KingsCollege Hosp NHS Fdn Trust, Dept Crit Care, London, England

[9] Univ Toronto, Interdept Div Crit Care Med, Toronto, ON, Canada

[10] Univ British Columbia, Div Crit Care, Vancouver Gen Hosp,Dept Med, Djavad Mowafaghian Ctr Brain Hlth Int,Ctr Repair, Vancouver, BC, Canada

[11] Univ Alberta, Dept Crit Care Med, Edmonton, AB, Canada

[12] Univ Alberta, Dept Med, Div Cardiol, Edmonton, AB, Canada

[13] Univ Ottawa, Dept Med, Div Cardiol, Inst Heart, Ottawa, ON, Canada

[14] Univ Toronto, Dept Med, Div Cardiol, Toronto, ON, Canada

[15] CHU Quebec, Dept Neurol Sci, Hop Enfant Jesus Quebec City, Quebec City, PQ, Canada

[16] Univ Calgary, Dept Med, Div Cardiol, Calgary, AB, Canada

[17] Univ Ottawa, Ottawa Hosp, Div Neurol, Ottawa, ON, Canada

[18] Duke Clin Res Inst, Durham, NC USA

[19] Univ Toronto, Dept Med, Div Cardiol, Toronto, ON, Canada

[20] Univ Hlth Network, Peter Munk Cardiac Ctr, Ted Rogers Ctr Heart Res, Toronto, ON, Canada

[21] Univ Ottawa, Inst Heart, CAPITAL Res Grp, Div Cardiol, Ottawa, ON, Canada

[22] Univ Ottawa, Fac Med, Div Crit Care, Ottawa, ON, Canada

[23] Univ Toronto, Interdept Div Crit Care Med, Toronto Western Hosp, Krembil Res Inst,Univ Hlth Network, Toronto, ON, Canada

[24] Sunnybrook Hlth Sci Ctr, Dept Crit Care Med, Toronto, ON, Canada

[25] Dalhousie Univ, Dept Emergency Med, Halifax, NS, Canada

[26] Dalhousie Univ, Dept Crit Care, Halifax, NS, Canada

[27] McGill Univ, Montreal Neurol Inst & Hosp, Neurol Intens Care Unit, Montreal, PQ, Canada

来源：

CANADIAN JOURNAL OF CARDIOLOGY | 2023年 / 39卷 / 04期

关键词：

TARGETED TEMPERATURE MANAGEMENT; EUROPEAN RESUSCITATION COUNCIL; MULTIMODAL OUTCOME PREDICTION; POSTANOXIC STATUS EPILEPTICUS; ADULT COMATOSE SURVIVORS; CARE MEDICINE GUIDELINES; THERAPEUTIC HYPOTHERMIA; CONTINUOUS EEG; PROGNOSTIC VALUE; CONTINUOUS ELECTROENCEPHALOGRAM;

D O I：

10.1016/j.cjca.2022.12.014

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Cardiac arrest (CA) is associated with a low rate of survival with favourable neurologic recovery. The most common mechanism of death after successful resuscitation from CA is withdrawal of life -sustaining measures on the basis of perceived poor neurologic prog-nosis due to underlying hypoxic-ischemic brain injury. Neuro-prognostication is an important component of the care pathway for CA patients admitted to hospital but is complex, challenging, and often guided by limited evidence. Using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system to eval-uate the evidence underlying factors or diagnostic modalities available to determine prognosis, recommendations were generated in the following domains: (1) circumstances immediately after CA; (2) focused neurologic exam; (3) myoclonus and seizures; (4) serum bio-markers; (5) neuroimaging; (6) neurophysiologic testing; and (7) multimodal neuroprognostication. This position statement aims to serve as a practical guide to enhance in-hospital care of CA patients and emphasizes the adoption of a systematic, multimodal approach to neuroprognostication. It also highlights evidence gaps.

引用

页码：366 / 380

页数：15