Cerebral Resuscitation After Cardiac Arrest

Oladi S. Bentho; Romergryko G. Geocadin

doi:10.1007/978-981-13-3390-3_30

Cerebral Resuscitation After Cardiac Arrest

Oladi S. Bentho
, Romergryko G. Geocadin

Neurology

Research output: Chapter in Book/Report/Conference proceeding › Chapter

Abstract

Cardiac arrest (CA) is a sudden loss of heart function due to either a primary cardiac event such as myocardial event or secondary effect on the heart from neurological, respiratory, or metabolic causes. At the epicenter of the high mortality and morbidity from CA, is the post-cardiac arrest syndrome, which includes anoxic brain injury, myocardial dysfunction, and a systemic ischemia and reperfusion syndrome. Of these, perception of injury to the brain is the most common cause of death in two-thirds of patients with OHCA and a quarter of patients with IHCA. This chapter will review the clinical manifestation of brain injury after a cardiac arrest, the pathophysiology of brain injury in this setting, the management post-CA, and neuroprognostication of patients post-CA.

Original language	English (US)
Title of host publication	Textbook of Neuroanesthesia and Neurocritical Care
Subtitle of host publication	Volume II - Neurocritical Care
Publisher	Springer Nature
Pages	411-420
Number of pages	10
Volume	2
ISBN (Electronic)	9789811333903
ISBN (Print)	9789811333897
DOIs	https://doi.org/10.1007/978-981-13-3390-3_30
State	Published - Jan 1 2019

Bibliographical note

Publisher Copyright:
© Springer Nature Singapore Pte Ltd. 2019.

Keywords

At the epicenter of the high mortality and morbidity from cardiac arrest, is the post-cardiac arrest syndrome, which includes anoxic brain injury, myocardial dysfunction, and a systemic ischemia and reperfusion syndrome.
Clinicians must use a multidisciplinary approach by combining experience with available clinical, neuroimaging, neurophysiological, and biomarkers data to counsel family regarding the prognosis of their loved ones.
Multiple factors play a role in the extent and pattern of brain injury post-cardiac arrest including the initial ischemic cascade, the reperfusion injury after return of spontaneous circulation (ROSC), the delay ischemia due to the no reflow phenomenon, and post-resuscitation variable such as pyrexia and hypoglycemia.
The brain is prone to injury due to lack of significant intrinsic energy and nutrient stores, therefore highly dependent on a constant supply of oxygen and nutrients.
Timing is key in prognostication as there are many confounding factors in early prognosis

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abstract = "Cardiac arrest (CA) is a sudden loss of heart function due to either a primary cardiac event such as myocardial event or secondary effect on the heart from neurological, respiratory, or metabolic causes. At the epicenter of the high mortality and morbidity from CA, is the post-cardiac arrest syndrome, which includes anoxic brain injury, myocardial dysfunction, and a systemic ischemia and reperfusion syndrome. Of these, perception of injury to the brain is the most common cause of death in two-thirds of patients with OHCA and a quarter of patients with IHCA. This chapter will review the clinical manifestation of brain injury after a cardiac arrest, the pathophysiology of brain injury in this setting, the management post-CA, and neuroprognostication of patients post-CA.",

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N2 - Cardiac arrest (CA) is a sudden loss of heart function due to either a primary cardiac event such as myocardial event or secondary effect on the heart from neurological, respiratory, or metabolic causes. At the epicenter of the high mortality and morbidity from CA, is the post-cardiac arrest syndrome, which includes anoxic brain injury, myocardial dysfunction, and a systemic ischemia and reperfusion syndrome. Of these, perception of injury to the brain is the most common cause of death in two-thirds of patients with OHCA and a quarter of patients with IHCA. This chapter will review the clinical manifestation of brain injury after a cardiac arrest, the pathophysiology of brain injury in this setting, the management post-CA, and neuroprognostication of patients post-CA.

AB - Cardiac arrest (CA) is a sudden loss of heart function due to either a primary cardiac event such as myocardial event or secondary effect on the heart from neurological, respiratory, or metabolic causes. At the epicenter of the high mortality and morbidity from CA, is the post-cardiac arrest syndrome, which includes anoxic brain injury, myocardial dysfunction, and a systemic ischemia and reperfusion syndrome. Of these, perception of injury to the brain is the most common cause of death in two-thirds of patients with OHCA and a quarter of patients with IHCA. This chapter will review the clinical manifestation of brain injury after a cardiac arrest, the pathophysiology of brain injury in this setting, the management post-CA, and neuroprognostication of patients post-CA.

KW - At the epicenter of the high mortality and morbidity from cardiac arrest, is the post-cardiac arrest syndrome, which includes anoxic brain injury, myocardial dysfunction, and a systemic ischemia and reperfusion syndrome.

KW - Clinicians must use a multidisciplinary approach by combining experience with available clinical, neuroimaging, neurophysiological, and biomarkers data to counsel family regarding the prognosis of their loved ones.

KW - Multiple factors play a role in the extent and pattern of brain injury post-cardiac arrest including the initial ischemic cascade, the reperfusion injury after return of spontaneous circulation (ROSC), the delay ischemia due to the no reflow phenomenon, a

KW - The brain is prone to injury due to lack of significant intrinsic energy and nutrient stores, therefore highly dependent on a constant supply of oxygen and nutrients.

KW - Timing is key in prognostication as there are many confounding factors in early prognosis

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Cerebral Resuscitation After Cardiac Arrest

Abstract

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