US EPA

7284656 

Journal Article 

Review 

Brain injury after cardiac arrest: from prognostication of comatose patients to rehabilitation 

Cronberg, T; Greer, DM; Lilja, G; Moulaert, V; Swindell, P; Rossetti, AO 

2020 

1 

The Lancet Neurology
ISSN: 1474-4422
EISSN: 1474-4465 

19 

7 

611-622 

English 

32562686 

WOS:000545358600018 

More patients are surviving cardiac arrest than ever before; however, the burden now lies with estimating neurological prognoses in a large number of patients who were initially comatose, in whom the ultimate outcome is unclear. Neurologists, neurointensivists, and clinical neurophysiologists must accurately balance the concern that overly conservative prognostication could leave patients in a severely disabled state, with the possibility that inaccurately pessimistic prognostication could lead to the withdrawal of life-sustaining treatment in patients who might otherwise have a good functional outcome. Prognostic tools have improved greatly, including electrophysiological tests, neuroimaging, and chemical biomarkers. Conclusions about the prognosis should be delayed at least 72 h after arrest to allow for the clearance of sedative drugs. Cognitive impairments, emotional problems, and fatigue are common among patients who have survived cardiac arrest, and often go unrecognised despite being related to caregiver burden and a decreased participation in society. Through simple screening, these problems can be identified, and patients can be provided with adequate information and rehabilitation.