Brain monitoring after cardiac arrest.
Journal
Current opinion in critical care
ISSN: 1531-7072
Titre abrégé: Curr Opin Crit Care
Pays: United States
ID NLM: 9504454
Informations de publication
Date de publication:
01 04 2023
01 04 2023
Historique:
pubmed:
11
2
2023
medline:
9
3
2023
entrez:
10
2
2023
Statut:
ppublish
Résumé
To describe the available neuromonitoring tools in patients who are comatose after resuscitation from cardiac arrest because of hypoxic-ischemic brain injury (HIBI). Electroencephalogram (EEG) is useful for detecting seizures and guiding antiepileptic treatment. Moreover, specific EEG patterns accurately identify patients with irreversible HIBI. Cerebral blood flow (CBF) decreases in HIBI, and a greater decrease with no CBF recovery indicates poor outcome. The CBF autoregulation curve is narrowed and right-shifted in some HIBI patients, most of whom have poor outcome. Parameters derived from near-infrared spectroscopy (NIRS), intracranial pressure (ICP) and transcranial Doppler (TCD), together with brain tissue oxygenation, are under investigation as tools to optimize CBF in patients with HIBI and altered autoregulation. Blood levels of brain biomarkers and their trend over time are used to assess the severity of HIBI in both the research and clinical setting, and to predict the outcome of postcardiac arrest coma. Neuron-specific enolase (NSE) is recommended as a prognostic tool for HIBI in the current postresuscitation guidelines, but other potentially more accurate biomarkers, such as neurofilament light chain (NfL) are under investigation. Neuromonitoring provides essential information to detect complications, individualize treatment and predict prognosis in patients with HIBI.
Identifiants
pubmed: 36762679
doi: 10.1097/MCC.0000000000001023
pii: 00075198-202304000-00005
pmc: PMC9994800
doi:
Substances chimiques
Biomarkers
0
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
68-74Informations de copyright
Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.
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