Neuroprognostication, withdrawal of care and long-term outcomes after cardiopulmonary resuscitation.

IF 3.5 3区 医学 Q1 CRITICAL CARE MEDICINE Current Opinion in Critical Care Pub Date : 2024-10-01 Epub Date: 2024-08-09 DOI:10.1097/MCC.0000000000001194
Adela Bazbaz, Joseph Varon
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Abstract

Purpose of review: Survivors of cardiac arrest often have increased long-term risks of mortality and disability that are primarily associated with hypoxic-ischemic brain injury (HIBI). This review aims to examine health-related long-term outcomes after cardiac arrest.

Recent findings: A notable portion of cardiac arrest survivors face a decline in their quality of life, encountering persistent physical, cognitive, and mental health challenges emerging years after the initial event. Within the first-year postarrest, survivors are at elevated risk for stroke, epilepsy, and psychiatric conditions, along with a heightened susceptibility to developing dementia. Addressing these challenges necessitates establishing comprehensive, multidisciplinary care systems tailored to the needs of these individuals.

Summary: HIBI remains the leading cause of disability among cardiac arrest survivors. No single strategy is likely to improve long term outcomes after cardiac arrest. A multimodal neuroprognostication approach (clinical examination, imaging, neurophysiology, and biomarkers) is recommended by guidelines, but fails to predict long-term outcomes. Cardiac arrest survivors often experience long-term disabilities that negatively impact their quality of life. The likelihood of such outcomes implements a multidisciplinary care an integral part of long-term recovery.

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心肺复苏术后的神经诊断、退出护理和长期疗效。
审查目的:心脏骤停幸存者的长期死亡和残疾风险通常会增加,这主要与缺氧缺血性脑损伤(HIBI)有关。本综述旨在研究心脏骤停后与健康相关的长期结果:最近的研究结果:相当一部分心脏骤停幸存者的生活质量下降,在最初事件发生数年后,他们在身体、认知和心理健康方面持续面临挑战。在心跳骤停后的第一年内,幸存者罹患中风、癫痫和精神疾病的风险较高,而且更容易患上痴呆症。要应对这些挑战,就必须针对这些人的需求建立全面的多学科护理系统。摘要:HIBI 仍是心脏骤停幸存者致残的主要原因。没有一种单一的策略可以改善心脏骤停后的长期预后。指南推荐采用多模式神经诊断方法(临床检查、成像、神经生理学和生物标志物),但无法预测长期结果。心脏骤停幸存者通常会出现长期残疾,对其生活质量造成负面影响。为避免出现这种结果,需要实施多学科护理,这也是长期康复不可或缺的一部分。
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来源期刊
Current Opinion in Critical Care
Current Opinion in Critical Care 医学-危重病医学
CiteScore
5.90
自引率
3.00%
发文量
172
审稿时长
6-12 weeks
期刊介绍: ​​​​​​​​​Current Opinion in Critical Care delivers a broad-based perspective on the most recent and most exciting developments in critical care from across the world. Published bimonthly and featuring thirteen key topics – including the respiratory system, neuroscience, trauma and infectious diseases – the journal’s renowned team of guest editors ensure a balanced, expert assessment of the recently published literature in each respective field with insightful editorials and on-the-mark invited reviews.
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