Neurological prognostication after cardiac arrest-Recommendations from the Swedish Resuscitation Council

被引:100
作者
Cronberg, Tobias [1 ]
Brizzi, Marco [2 ]
Liedholm, Lars Johan [3 ]
Rosen, Ingmar [4 ]
Rubertsson, Sten [5 ]
Rylander, Christian [6 ]
Friberg, Hans [7 ]
机构
[1] Lund Univ, Dept Clin Sci, Div Neurol, Lund, Sweden
[2] Lund Univ, Dept Clin Sci, Div Neurol, Malmo, Sweden
[3] Univ Orebro, Dept Neurol & Clin Neurophysiol, Orebro, Sweden
[4] Lund Univ, Dept Clin Sci, Div Neurophysiol, Lund, Sweden
[5] Uppsala Univ, Dept Surg Sci Anaesthesiol & Intens Care, Uppsala, Sweden
[6] Univ Gothenburg, Dept Clin Sci Anaesthesiol & Intens Care, Gothenburg, Sweden
[7] Lund Univ, Dept Clin Sci, Div Intens & Perioperat Care, Lund, Sweden
关键词
Cardiac arrest; Prognosis; Neurological outcome; Hypothermia; Guidelines; NEURON-SPECIFIC ENOLASE; BILATERAL ABSENT N20; THERAPEUTIC HYPOTHERMIA; COMATOSE SURVIVORS; COMPUTED-TOMOGRAPHY; MILD HYPOTHERMIA; PREDICTIVE-VALUE; BRAIN; PROGNOSIS; DIFFUSION;
D O I
10.1016/j.resuscitation.2013.01.019
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Cardiopulmonary resuscitation is started in 5000 victims of out-of-hospital cardiac arrest in Sweden each year and the survival rate is approximately 10%. The subsequent development of a global ischaemic brain injury is the major determinant of the neurological prognosis for those patients who reach the hospital alive. Induced hypothermia is a recommended treatment after cardiac arrest and has been implemented in most Swedish hospitals. Recent studies indicate that induced hypothermia may affect neurological prognostication and previous international recommendations are therefore no longer valid when hypothermia is applied. An expert group from the Swedish Resuscitation Council has reviewed the literature and made recommendations taking into account the effects of induced hypothermia and concomitant sedation. A delayed neurological evaluation at 72 h after rewarming is recommended for hypothermia treated patients. This evaluation should be based on several independent methods and the possibility of lingering pharmacological effects should be considered. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:867 / 872
页数:6
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