Targeted temperature management and neuroprognostication after cardiac arrest: A survey in Belgium

Abstract

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.

Target temperature management after cardiac arrest in comatose survivors in Brazil – A survey of the current clinical practice

“…Besides controversies concerning the best temperature to be achieved in comatose survivors after CA, there is still a tendency in Brazil to induce hypothermia for those patients, despite the rhythm. These results are in line with the clinical practice demonstrated in Belgium, by Taccone et al [3]. Another survey performed in France, with more than 3000 doctors showed very similar results − about 56% of doctors still induce hypothermia (32-34 • ) in comatose patients after CA.…”

Post-resuscitation care in large and small University and community hospitals in Italy

“…This survey showed a high rate of implementation of TTM and SOPs in post-resuscitation care in Italy, as also previously reported by other national surveys [4,5]. Overall, a better post-resuscitation care was observed in ICUs that admitted more than 10 CAs/year, compared to those with a smaller admission of CAs (Fig.…”

The first national survey on practices of neurological prognostication after cardiac arrest in China, still a lot to do

“…Only 11.4% had performed EEG in routine practice in this study. However, recent surveys reported the widely use of EEG in CA patients 19,20 . Friberg et al reported that 74% of members from European Society of Emergency Medicine had used intermittent EEG or continuous EEG for CA patients in practice 20 .…”

“…However, recent surveys reported the widely use of EEG in CA patients. 19,20 Friberg et al reported that 74% of members from European Society of Emergency Medicine had used intermittent EEG or continuous EEG for CA patients in practice. 20 The low level utility of EEG in China is likely due to several causes.…”