Prognosis of Cardiac Arrest-Peri-arrest and Post-arrest Considerations

Abstract

There has been only a small improvement in survival and neurologic outcomes in patients with cardiac arrest in recent decades. Type of arrest, length of total arrest time, and location of arrest alter the trajectory of survival and neurologic outcome. In the post-arrest phase, clinical markers such as blood markers, pupillary light response, corneal reflex, myoclonic jerking, somatosensory evoked potential, and electroencephalography testing can be used to help guide neurological prognostication. Most of the testing should be performed 72 hours post-arrest with special considerations for longer observation periods in patients who underwent TTM or who had prolonged sedation and/or neuromuscular blockade.

Keywords: Brainstem reflexes; Cardiac arrest; Neuron-specific enolase (NSE); Neuroprognostication; Postcardiac arrest; Somatosensory evoked potentials (SSEP).