Neuroprognostication after adult cardiac arrest treated with targeted temperature management: task force for Belgian recommendations.
The prognosis of patients who are admitted to the hospital after cardiac arrest often relies on neurological examination, which could be significantly influenced by the use of sedative drugs or the implementation of targeted temperature management. The need for early and accurate prognostication is crucial as up to 15-20% of patients could be considered as having a poor outcome and may undergo withdrawal of life-sustaining therapies while a complete neurological recovery is still possible. As current practice in Belgium is still based on a very early assessment of neurological function in these patients, the Belgian Society of Intensive Care Medicine created a multidisciplinary Task Force to provide an optimal approach for monitoring and refine prognosis of CA survivors. This Task Force underlined the importance to use a multimodal approach using several additional tools (e.g., electrophysiological tests, neuroimaging, biomarkers) and to refer cases with uncertain prognosis to specialized centers to better evaluate the extent of brain injury in these patients.
Department of Intensive Care, Hôpital Erasme, Université Libre de Bruxelles (ULB), Route de Lennik, 808, 1070, Brussels, Belgium.
Fabio Silvio
FS
Taccone
Department of Neurology, Antwerp University Hospital, 2650, Edegem, Belgium.
Ingrid
I
Baar
Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg ZOL, Schiepse Bos 6, 3600, Genk, Belgium.
Cathy
C
De Deyne
Department of Intensive Care, Ghent University Hospital, De Pintelaan, 185, 9000, Ghent, Belgium.
Patrick
P
Druwe
Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles (ULB), Route de Lennik, 808, 1070, Brussels, Belgium. blegros@ulb.ac.be.
Benjamin
http://orcid.org/0000-0002-9938-7457
B
Legros
Department of Intensive Care, UZ Leuven, Herestraat 49, box 7003 63, 3000, Leuven, Belgium.
Geert
G
Meyfroidt
Department of Neurology, CHU UCL Namur, Université Catholique de Louvain, Avenue Gaston Thérasse, 1, 5530, Yvoir, Belgium.
Michel
M
Ossemann
Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles (ULB), Route de Lennik, 808, 1070, Brussels, Belgium.
Nicolas
N
Gaspard
D003422:Critical Care / Q000379:methods*; D006323:Heart Arrest / Q000150:complications* / Q000628:therapy; D006801:Humans; D007036:Hypothermia, Induced; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D009460:Neurologic Examination / Q000379:methods*; D011379:Prognosis; D020127:Recovery of Function
Biomarkers; Cardiac arrest; EEG; Evoked potentials; Hypothermia; Neurological examination; Prognosis