Christopher B Fordyce, Andreas H Kramer, Craig Ainsworth, Jim Christenson, Gary Hunter, Julie Kromm, Carmen Lopez Soto, Damon C Scales, Mypinder Sekhon, Sean van Diepen, Laura Dragoi, Colin Josephson, Jim Kutsogiannis, Michel R Le May, Christopher B Overgaard, Martin Savard, Gregory Schnell, Graham C Wong, Emilie Belley-Côté, Tadeu A Fantaneanu, Christopher B Granger, Adriana Luk, Rebecca Mathew, Victoria McCredie, Laurel Murphy, Jeanne Teitelbaum
Cardiac arrest (CA) is associated with a low rate of survival with favourable neurologic recovery. The most common mechanism of death after successful resuscitation from CA is withdrawal of life-sustaining measures on the basis of perceived poor neurologic prognosis due to underlying hypoxic-ischemic brain injury. Neuroprognostication is an important component of the care pathway for CA patients admitted to hospital but is complex, challenging, and often guided by limited evidence. Using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system to evaluate the evidence underlying factors or diagnostic modalities available to determine prognosis, recommendations were generated in the following domains: (1) circumstances immediately after CA; (2) focused neurologic exam; (3) myoclonus and seizures; (4) serum biomarkers; (5) neuroimaging; (6) neurophysiologic testing; and (7) multimodal neuroprognostication...
April 2023: Canadian Journal of Cardiology