[Early evaluation of neurological prognosis and therapy after cardiopulmonary resuscitation: current opportunities and clinical implications].
The developments of cardiopulmonary resuscitation and intensive care medicine have made possible survival after cardiac arrest. However, only 10-30% of patients with initially successful resuscitation later reach a state without severe neurological impairment. Ethical and socioeconomic reasons therefore make early prognosis important for certain patients. There are no reliable parameters for predictions of good clinical outcome. If clinical information is consistent with severe hypoxic brain damage, cortical somatosensory evoked potentials are absent, and neuron-specific enolase values exceed 33-65 microg/l, recovery of consciousness can be excluded. The same result can be predicted if brain imaging shows severe hypoxemic changes or if a myoclonic status occurs on the first day. In summary, the prognosis in patients with cerebral anoxy and cardiopulmonary resuscitation remains poor. Treatment with hypothermia for 24 h is recommended.
Ragoschke-Schumm
A
A
Institut für Diagnostische und Interventionelle Radiologie, Jena, Germany.
Pfeifer
R
R
Marx
G
G
Knoepffler
N
N
Witte
O W
OW
Isenmann
S
S
D015415:Biomarkers / Q000097:blood; D001921:Brain / Q000473:pathology; D001925:Brain Damage, Chronic / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D042241:Early Diagnosis; D004569:Electroencephalography; D004992:Ethics, Medical; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006801:Humans; D002534:Hypoxia, Brain / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D009460:Neurologic Examination; D018458:Persistent Vegetative State / Q000175:diagnosis / Q000401:mortality; D010751:Phosphopyruvate Hydratase / Q000097:blood; D011379:Prognosis; D016414:Resuscitation Orders / Q000941:ethics; D014057:Tomography, X-Ray Computed
D015415:Biomarkers; D010751:Phosphopyruvate Hydratase