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Brain injury after cardiac arrest: from prognostication of comatose patients to rehabilitation.
Journal article

Brain injury after cardiac arrest: from prognostication of comatose patients to rehabilitation.

  • Cronberg T Department of Clinical Sciences, Neurology, Lund University, Skane University Hospital, Lund, Sweden. Electronic address: tobias.cronberg@skane.se.
  • Greer DM Department of Neurology, Boston University School of Medicine, Boston, MA, USA.
  • Lilja G Department of Clinical Sciences, Neurology, Lund University, Skane University Hospital, Lund, Sweden.
  • Moulaert V Department of Rehabilitation Medicine, University of Groningen, University Medical Centre Groningen, Netherlands.
  • Swindell P Sudden Cardiac Arrest UK, Essex, UK.
  • Rossetti AO Department of Clinical Neurosciences, University Hospital and University of Lausanne, Lausanne, Switzerland.
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  • 2020-06-21
Published in:
  • The Lancet. Neurology. - 2020
Brain Injuries
Coma
Heart Arrest
Humans
Hypoxia, Brain
Prognosis
English More patients are surviving cardiac arrest than ever before; however, the burden now lies with estimating neurological prognoses in a large number of patients who were initially comatose, in whom the ultimate outcome is unclear. Neurologists, neurointensivists, and clinical neurophysiologists must accurately balance the concern that overly conservative prognostication could leave patients in a severely disabled state, with the possibility that inaccurately pessimistic prognostication could lead to the withdrawal of life-sustaining treatment in patients who might otherwise have a good functional outcome. Prognostic tools have improved greatly, including electrophysiological tests, neuroimaging, and chemical biomarkers. Conclusions about the prognosis should be delayed at least 72 h after arrest to allow for the clearance of sedative drugs. Cognitive impairments, emotional problems, and fatigue are common among patients who have survived cardiac arrest, and often go unrecognised despite being related to caregiver burden and a decreased participation in society. Through simple screening, these problems can be identified, and patients can be provided with adequate information and rehabilitation.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://folia.unifr.ch/global/documents/55618
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