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Neuroprognostication in the Post Cardiac Arrest Patient: A Canadian Cardiovascular Society Position Statement
Christopher B Fordyce1, Andreas H Kramer2, Craig Ainsworth3
1Division of Cardiology, Department of Medicine, Vancouver General Hospital, and the Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, British Columbia.
The Canadian Journal of Cardiology
|April 7, 2023
Summary
Accurate neuroprognostication after cardiac arrest (CA) is crucial for patient survival and recovery. This guide offers a systematic, multimodal approach to predicting neurologic outcomes following CA resuscitation.
Area of Science:
- Critical Care Medicine
- Neurology
- Cardiology
Background:
- Cardiac arrest (CA) survivors face poor neurologic recovery, often leading to withdrawal of care.
- Accurate neuroprognostication is vital but challenging due to hypoxic-ischemic brain injury.
- Limited evidence currently guides neuroprognostication in post-CA patients.
Framework:
- Utilized the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system.
- Evaluated evidence for factors and diagnostic modalities in neuroprognostication.
- Generated recommendations across seven key domains.
Implementation:
- Focused neurologic examination
- Assessment of myoclonus and seizures
- Serum biomarkers
- Neuroimaging
- Neurophysiologic testing
- Multimodal neuroprognostication strategies
Implications:
- Aims to enhance in-hospital care for cardiac arrest patients.
- Emphasizes a systematic, multimodal approach to neuroprognostication.
- Highlights existing evidence gaps for future research.
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