Hypoxic-ischaemic brain injury (HIBI) is the main cause of death in patients who are comatose after resuscitation from cardiac arrest. A poor neurological outcome-defined as death from neurological cause, persistent vegetative state, or severe neurological disability-can be predicted in these patients by assessing the severity of HIBI. The most commonly used indicators of severe HIBI include bilateral absence of corneal and pupillary reflexes, bilateral absence of N 2 O waves of short-latency somatosensory evoked potentials, high blood concentrations of neuron specific enolase, unfavourable patterns on electroencephalogram, and signs of diffuse HIBI on computed tomography or magnetic resonance imaging of the brain. Current guidelines recommend performing prognostication no earlier than 72 h after return of spontaneous circulation in all comatose patients with an absent or extensor motor response to pain, after having excluded confounders such as residual sedation that may interfere with clinical examination. A multimodal approach combining multiple prognostication tests is recommended so that the risk of a falsely pessimistic prediction is minimised.

Sandroni, C., D'arrigo, S., Nolan, J. P., Prognostication after cardiac arrest, <<CRITICAL CARE>>, 2018; 22 (1): 150-159. [doi:10.1186/s13054-018-2060-7] [http://hdl.handle.net/10807/131839]

Prognostication after cardiac arrest

Sandroni, Claudio
Primo
Supervision
;
D'Arrigo, Sonia
Secondo
Writing – Original Draft Preparation
;
2018

Abstract

Hypoxic-ischaemic brain injury (HIBI) is the main cause of death in patients who are comatose after resuscitation from cardiac arrest. A poor neurological outcome-defined as death from neurological cause, persistent vegetative state, or severe neurological disability-can be predicted in these patients by assessing the severity of HIBI. The most commonly used indicators of severe HIBI include bilateral absence of corneal and pupillary reflexes, bilateral absence of N 2 O waves of short-latency somatosensory evoked potentials, high blood concentrations of neuron specific enolase, unfavourable patterns on electroencephalogram, and signs of diffuse HIBI on computed tomography or magnetic resonance imaging of the brain. Current guidelines recommend performing prognostication no earlier than 72 h after return of spontaneous circulation in all comatose patients with an absent or extensor motor response to pain, after having excluded confounders such as residual sedation that may interfere with clinical examination. A multimodal approach combining multiple prognostication tests is recommended so that the risk of a falsely pessimistic prediction is minimised.
Inglese
http://ccforum.com/content/17
Sandroni, C., D'arrigo, S., Nolan, J. P., Prognostication after cardiac arrest, <>, 2018; 22 (1): 150-159. [doi:10.1186/s13054-018-2060-7] [http://hdl.handle.net/10807/131839]
File in questo prodotto:
File Dimensione Formato  
Sandroni Prognnostication after CA Critical Care 2018.pdf

accesso aperto

Tipologia file ?: Versione Editoriale (PDF)
Licenza: Creative commons
Dimensione 846.65 kB
Formato Adobe PDF
846.65 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10807/131839
Citazioni
  • ???jsp.display-item.citation.pmc??? 40
  • Scopus 117
  • ???jsp.display-item.citation.isi??? 110
social impact