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Neurological Prognostication After Cardiac Arrest in the Era of Target Temperature Management

  • Maximiliano A. HawkesEmail author
  • Alejandro A. Rabinstein
Neurology of Systemic Diseases (J Biller, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Neurology of Systemic Disease

Abstract

Purpose of Review

The purpose of this study is to provide an updated review on neurological prognostication in comatose patients after cardiac arrest in light of current targeted temperature management (TTM) strategies.

Recent Findings

With improved pre-hospital and hospital care, death due to cardiac arrest is decreasing. Yet, most survivors have poor neurological outcomes. While TTM has demonstrated to improve neurological outcomes, it may cloud our prognostic accuracy. A multimodal approach is currently used to diminish prognostic uncertainty.

Summary

The neurological examination remains the mainstay for prognosis after cardiac arrest. The combination electroencephalogram, somatosensory evoked potentials, and neuron-specific enolase improve prognostic accuracy, mostly in patients who underwent TTM. Quantitative analysis of pupillary reaction and EEG background variability, neuroimaging (CT perfusion and DWI-MRI), and middle/long-latency evoked potentials are promising methods that may further improve the precision of outcome prognostication.

Keywords

Cardiac arrest Target temperature management Prognosis 

Notes

Compliance with Ethical Standards

Conflict of Interest

Maximiliano Hawkes and Alejandro Rabinstein each declare no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Maximiliano A. Hawkes
    • 1
    Email author
  • Alejandro A. Rabinstein
    • 2
  1. 1.Departments of Neurology and Internal MedicineFLENICiudad de Buenos AiresArgentina
  2. 2.Department of NeurologyMayo ClinicRochesterUSA

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