Brain-Oriented Intensive Care: Standardization of Postresuscitation Therapy
In the United States and in other developed countries, approximately 200 people per 1 million inhabitants are being successfully resuscitated from out-of-hospital cardiac arrest each year. The secondary survival rate, that is, the proportion of patients surviving hospitalization, varies widely and some large metropolitan cities such as Chicago and New York have reported surprisingly low secondary survival rates of out-of-hospital cardiac arrest [1,2]. Of patients admitted to the hospital, more than one-half will die within a few weeks, many of them of hypoxic-ischemic encephalopathy. Hypoxic-ischemic encephalopathy with severe cognitive dysfunction or vegetative state is a feared consequence of cardiac arrest. The severity of global ischemic brain injury cannot be reliably assessed by any conventional neuroradiological or neurophysiological method, nor are there any laboratory tests to differentiate between subsequent recovery and death in comatose patients soon after cardiac arrest.
KeywordsCardiac Arrest Global Ischemia Severe Head Injury Global Cerebral Ischemia Advanced Life Support
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