Validation of the rCAST score and comparison to the PCAC and FOUR scores for prognostication after out-of-hospital cardiac arrest

Kim, Noah; Kitlen, Eva; Garcia, Gabriella; Khosla, Akhil; Miller, P. Elliott; Johnson, J. Kristie; Wira, Charles; Greer, David M.; Gilmore, Emily J.; Beekman, Rachel

doi:10.1016/j.resuscitation.2023.109832

Cited by 5 publications

(2 citation statements)

References 23 publications

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“…After arrest, patients with ST elevations on ECG require immediate coronary angiography 23-25 . Timing of percutaneous coronary interventions for patients without ST elevations is controversial and requires an individualized approach ( case 2-1 ) 26,27 . Mechanical circulatory support (ie, extracorporeal membrane oxygenation, intraaortic balloon pump) may benefit unstable patients; the use of these interventions typically requires multidisciplinary discussion.…”

Section: Pathophysiology and Prevention Of Secondary Brain Injurymentioning

confidence: 99%

“…A neurologist may be asked for early risk stratification in this context. The degree of initial brain and systemic injury can be categorized by using risk stratification scores (ie, Pittsburgh Cardiac Arrest Category, revised post-Cardiac Arrest Syndrome for Therapeutic hypothermia [rCAST], and Full Outline of UnResponsiveness [FOUR]) 26,27 . A neurologist’s views on the patient’s severity of injury may help clinical teams decide about performing aggressive interventions (ie, extracorporeal membrane oxygenation or cardiac catheterization).…”

Section: Pathophysiology and Prevention Of Secondary Brain Injurymentioning

confidence: 99%

See 1 more Smart Citation

Emergent Management of Hypoxic-Ischemic Brain Injury

Steinberg

2024

CONTINUUM: Lifelong Learning in Neurology

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OBJECTIVE This article outlines interventions used to improve outcomes for patients with hypoxic-ischemic brain injury after cardiac arrest. LATEST DEVELOPMENTS Emergent management of patients after cardiac arrest requires prevention and treatment of primary and secondary brain injury. Primary brain injury is minimized by excellent initial resuscitative efforts. Secondary brain injury prevention requires the detection and correction of many pathophysiologic processes that may develop in the hours to days after the initial arrest. Key physiologic parameters important to secondary brain injury prevention include optimization of mean arterial pressure, cerebral perfusion, oxygenation and ventilation, intracranial pressure, temperature, and cortical hyperexcitability. This article outlines recent data regarding the treatment and prevention of secondary brain injury. Different patients likely benefit from different treatment strategies, so an individualized approach to treatment and prevention of secondary brain injury is advisable. Clinicians must use multimodal sources of data to prognosticate outcomes after cardiac arrest while recognizing that all prognostic tools have shortcomings. ESSENTIAL POINTS Neurologists should be involved in the postarrest care of patients with hypoxic-ischemic brain injury to improve their outcomes. Postarrest care requires nuanced and patient-centered approaches to the prevention and treatment of primary and secondary brain injury and neuroprognostication.

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Section: Pathophysiology and Prevention Of Secondary Brain Injurymentioning

confidence: 99%

Section: Pathophysiology and Prevention Of Secondary Brain Injurymentioning

confidence: 99%