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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
PubMed

Insights

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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