Actualización del manejo postparo cardiaco y pronóstico en la era de la hipotermia terapéutica
An update in postcardiac arrest management and prognosis in the era of therapeutic hypothermia.
Cahill EA, Tirschwell DL, Khot S.
Neurohospitalist. 2014 Jul;4(3):144-52. doi: 10.1177/1941874413509632.
Abstract
Prognostication of patients who remain comatose following successful resuscitation after cardiac arrest has long posed a challenge for the consulting neurologist. With increasing rates of early defibrillation, out-of-hospital cardiopulmonary resuscitation, and expanding use of therapeutic hypothermia, prognostication in hypoxic-ischemic encephalopathy has become an increasingly common consult for neurologists. Much of the data we previously relied upon for prognostication were taken from patients who were not treated with therapeutic hypothermia. In this review, we examine useful prognostic tools and markers, including the physical examination, evaluation of myoclonus, electroencephalogram monitoring, somatosensory-evoked potentials, biochemical markers of neuronal injury, and neuroimaging. Neurologists must avoid overly pessimistic prognostic statements regarding survival, awakening from coma, or future quality of life, as such statements may unduly influence decisions regarding the continuation of life-sustaining treatment. Conversely, continuation of aggressive medical management in a patient without any hope of awakening should also be avoided. Thus, an understanding of the utility and the limitations of these prognostic tools in the era of therapeutic hypothermia is essential.
KEYWORDS: brain; cerebrovascular disorders; clinical specialty; electroencephalography; evoked potentials; hypoxia-ischemia; neurocritical care; neurohospitalist; techniques
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4056412/pdf/10.1177_1941874413509632.pdf
Principales complicaciones de la hipotermia leve después de paro cardiaco. Revisión
Main complications of mild induced hypothermia after cardiac arrest: a review article.
Soleimanpour H, Rahmani F, Golzari SE, Safari S.
J Cardiovasc Thorac Res. 2014;6(1):1-8. doi: 10.5681/jcvtr.2014.001. Epub 2014 Mar 21.
Abstract
The aim of the present study is to assess the complications of mild induced hypothermia (MIH) in patients with cardiac arrest. Presently, based on the guidelines of the American heart Association, MIH following successful cardiopulmonary resuscitation (CPR) in unconscious adult patients due to ventricular fibrillation (VF) with out-of-hospital cardiac arrest (OOHCA) is essential and required. However, MIH could be associated with complications in Patients with cardiac arrest. Studies conducted on the precautions and care following cardiac arrest and MIH were included. Valid scientific data bases were used for data collection. The obtained results from different studies revealed that mild MIH could be associated with numerous complications and the knowledge and awareness of the medical staff from the complications is required to guarantee successfultherapeutic approaches in MIH following cardiac arrest which is a novel medical facility with different styles and complications. Overall, further future studies are required to improve the quality of MIH, to increase survival and to decrease complications rates.
KEYWORDS: Cardiac Arrest; Cardiopulmonary Resuscitation; Hypothermia
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3992725/pdf/jcvtr-6-1.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
An update in postcardiac arrest management and prognosis in the era of therapeutic hypothermia.
Cahill EA, Tirschwell DL, Khot S.
Neurohospitalist. 2014 Jul;4(3):144-52. doi: 10.1177/1941874413509632.
Abstract
Prognostication of patients who remain comatose following successful resuscitation after cardiac arrest has long posed a challenge for the consulting neurologist. With increasing rates of early defibrillation, out-of-hospital cardiopulmonary resuscitation, and expanding use of therapeutic hypothermia, prognostication in hypoxic-ischemic encephalopathy has become an increasingly common consult for neurologists. Much of the data we previously relied upon for prognostication were taken from patients who were not treated with therapeutic hypothermia. In this review, we examine useful prognostic tools and markers, including the physical examination, evaluation of myoclonus, electroencephalogram monitoring, somatosensory-evoked potentials, biochemical markers of neuronal injury, and neuroimaging. Neurologists must avoid overly pessimistic prognostic statements regarding survival, awakening from coma, or future quality of life, as such statements may unduly influence decisions regarding the continuation of life-sustaining treatment. Conversely, continuation of aggressive medical management in a patient without any hope of awakening should also be avoided. Thus, an understanding of the utility and the limitations of these prognostic tools in the era of therapeutic hypothermia is essential.
KEYWORDS: brain; cerebrovascular disorders; clinical specialty; electroencephalography; evoked potentials; hypoxia-ischemia; neurocritical care; neurohospitalist; techniques
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4056412/pdf/10.1177_1941874413509632.pdf
Principales complicaciones de la hipotermia leve después de paro cardiaco. Revisión
Main complications of mild induced hypothermia after cardiac arrest: a review article.
Soleimanpour H, Rahmani F, Golzari SE, Safari S.
J Cardiovasc Thorac Res. 2014;6(1):1-8. doi: 10.5681/jcvtr.2014.001. Epub 2014 Mar 21.
Abstract
The aim of the present study is to assess the complications of mild induced hypothermia (MIH) in patients with cardiac arrest. Presently, based on the guidelines of the American heart Association, MIH following successful cardiopulmonary resuscitation (CPR) in unconscious adult patients due to ventricular fibrillation (VF) with out-of-hospital cardiac arrest (OOHCA) is essential and required. However, MIH could be associated with complications in Patients with cardiac arrest. Studies conducted on the precautions and care following cardiac arrest and MIH were included. Valid scientific data bases were used for data collection. The obtained results from different studies revealed that mild MIH could be associated with numerous complications and the knowledge and awareness of the medical staff from the complications is required to guarantee successfultherapeutic approaches in MIH following cardiac arrest which is a novel medical facility with different styles and complications. Overall, further future studies are required to improve the quality of MIH, to increase survival and to decrease complications rates.
KEYWORDS: Cardiac Arrest; Cardiopulmonary Resuscitation; Hypothermia
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3992725/pdf/jcvtr-6-1.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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