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KMID : 1201420140070010016
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Journal of Neurocritical Care
2014 Volume.7 No. 1 p.16 ~ p.24
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Prognostic Assessments during Therapeutic Hypothermia after Cardiac Arrest
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Cho Yang-Je
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Abstract
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Integrated post-resuscitation treatment has improved the outcome of the unconscious patients with cardiac arrest after introduction of the therapeutic hypothermia, which had shown promising results in the two pivotal randomized trials. Early assessment of neurological function and prognostication in these comatose patients has been challenging problem, and the introduction of therapeutic hypothermia made the problem more confusing. Various clinical situations, the results of the clinical neurologic examination, neurophysiologic monitoring including electroencephalography and somatosensory evoked potentials, various biomarkers, and neuroimaging can be used in predicting early prognosis. No single test is allowed to predict the prognosis with certainty, and a multimodal strategy is generally recommended. The previous practice guideline of the American Academy of Neurology in 2006 may not be appropriate anymore in the era of therapeutic hypothermia. In this review, the author introduces various neuromonitoring methods currently used in the therapeutic hypothermia and evaluate the their role in the prognostication with available evidences.
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KEYWORD
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Therapeutic hypothermia, Prognostication, Cardiac arrest, Outcomes, Anoxic brain injury
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