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Published on: April 14, 2023
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Survey on current practices for neurological prognostication after cardiac arrest
Hans Friberg1, Tobias Cronberg2, Martin W Dünser3
1Skåne University Hospital, Department of Anaesthesiology and Intensive Care, Lund University, Sweden.
Resuscitation
|February 14, 2015
Summary
Neurological prognostication in comatose cardiac arrest patients lacks national guidelines and separate protocols for hypothermia. A multimodal approach using EEG, CT, and EP is preferred over neurological exam alone.
Area of Science:
- Critical Care Medicine
- Neurology
- Cardiology
Background:
- Neurological prognostication is crucial for comatose cardiac arrest survivors.
- Induced hypothermia is a common post-cardiac arrest treatment.
- Standardized prognostication protocols are lacking.
Purpose of the Study:
- To investigate current practices and timing of neurological prognostication in comatose cardiac arrest patients.
- To assess the use of national recommendations and specific protocols for hypothermia-treated patients.
- To identify preferred methods for predicting neurological outcome.
Main Methods:
- Anonymous questionnaire distributed to European Society of Intensive Care Medicine members.
- Survey included 27 questions on background, clinical data, decision-making, and consequences.
- Data collected from 1025 respondents (13% response rate).
Main Results:
- Only 22% of respondents reported national recommendations for prognostication.
- 89% used induced hypothermia; only 20% had separate prognostication protocols for these patients.
- Neurological examination alone was deemed insufficient; EEG, CT, and EP were favored as additional methods.
Conclusions:
- National recommendations for neurological prognostication after cardiac arrest are uncommon.
- A multimodal approach (EEG, CT, EP) is favored over neurological examination alone.
- Substantial uncertainty exists regarding prognostication and withdrawal of care decisions.
