Prognosis for Brain Function Following Cardiopulmonary Resuscitation and Therapeutic Hypothermia

Mild therapeutic hypothermia has become a standard treatment and has markedly improved the prognosis of patients after cardiac arrest and resuscitation. An increasing number of recent studies has shown that therapeutic hypothermia influences the prognostic value of clinical, laboratory and electrophysiological parameters in these patients. Hence, a re-evaluation of these parameters appears necessary. Specifically, motor response to painful stimuli and a serum concentration of neuron specific enolase (NSE) of > 33 mu g/l tested on day 3 after resuscitation do no longer allow for valid prognosis of the possibility of re-awakening. Facing the heterogeneous results from recent studies, prognosis in patients treated with hypothermia after cardiac arrest should always be based on careful interpretation of several prognostic parameters.