Prognosis After Cardiac Arrest and Hypothermia: A New Paradigm

Edgar A Samaniego; Suzanne Persoon; Christine A.C Wijman

doi:10.1007/s11910-010-0148-9

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Prognosis After Cardiac Arrest and Hypothermia: A New Paradigm

Journal article

Peer reviewed

Prognosis After Cardiac Arrest and Hypothermia: A New Paradigm

Edgar A Samaniego, Suzanne Persoon and Christine A.C Wijman

Current neurology and neuroscience reports, Vol.11(1), pp.111-119

02/2011

DOI: 10.1007/s11910-010-0148-9

PMCID: PMC3357920

PMID: 20927660

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https://www.ncbi.nlm.nih.gov/pmc/articles/3357920View

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Abstract

Before the use of hypothermia as a treatment for comatose post-cardiac arrest patients, several prognostic variables were widely accepted as reliable and valid for the prediction of poor outcome. Recent studies using hypothermia have reported on patients with recovery of consciousness in spite of absent or extensor motor responses after 3 days, absent bilateral cortical N20 responses after 24 hours, serum neuron-specific enolase levels greater than 33 μg/L, and early myoclonus status epilepticus. Hypothermia and its associated use of sedative and paralytic agents may delay neurologic recovery and affect the optimal timing of prognostic variables. Recent developments in brain imaging may provide additional objective prognostic information and deserve further study. Pending the results of future validation studies in patients treated with hypothermia, we recommend that irreversible management decisions not be made based on a single prognostic parameter, and, if there is uncertainty, these decisions be delayed for several days to allow for repeated testing.

Coma

Neuron-specific enolase, S100B protein

Prognostication

Brain magnetic resonance imaging

Somatosensory evoked potentials

Cardiac arrest

Neurological examination

Myoclonus status epilepticus

Electroencephalography

Hypothermia

Details

Title: Subtitle: Prognosis After Cardiac Arrest and Hypothermia: A New Paradigm
Creators: Edgar A Samaniego - Stanford Neurocritical Care Program, Stanford Stroke Center, Department of Neurology and Neurological Sciences, Stanford University, USA
Suzanne Persoon - Stanford Neurocritical Care Program, Stanford Stroke Center, Department of Neurology and Neurological Sciences, Stanford University, USA
Christine A.C Wijman - Department of Neurology, University Medical Center Utrecht, The Netherlands
Resource Type: Journal article
Publication Details: Current neurology and neuroscience reports, Vol.11(1), pp.111-119
DOI: 10.1007/s11910-010-0148-9
PMID: 20927660
PMCID: PMC3357920
NLM abbreviation: Curr Neurol Neurosci Rep
ISSN: 1528-4042
eISSN: 1534-6293
Grant note: R01 HL089116-04 || HL / National Heart, Lung, and Blood Institute : NHLBI
Language: English
Date published: 02/2011
Academic Unit: Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
Record Identifier: 9984020605202771

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