Geocadin Romergryko G, Agarwal Sachin, Goss Adeline L, Callaway Clifton W, Richie Megan
Departments of Neurology, Anesthesiology-Critical Care Medicine and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Department of Neurology (Neurocritical Care), Columbia University Irving Medical Center, New York, NY, United States.
Ann Neurol. 2023 May;93(5):871-876. doi: 10.1002/ana.26619. Epub 2023 Mar 13.
The association between brain injury after cardiac arrest and poor survival outcomes has led to longstanding pessimism. However, the publicly witnessed cardiac arrest, resuscitation, and acute management of Mr. Damar Hamlin and his favorable neurologic recovery provides some optimism. Mr. Hamlin's case highlights the neurologic advances of the last 2 decades and presents the opportunity to improve outcomes for all cardiac arrest patients in key areas: (1) effectively implementing the American Heart Association "Chain of Survival" to prevent initial brain injury and promote neuroprotection; (2) revisiting the process of neurologic prognostication and re-defining the brain recovery during the early periods, and (3) incorporating neurorehabilitation into existing cardiac rehabilitation models to support holistic recovery. ANN NEUROL 2023;93:871-876.
心脏骤停后发生脑损伤与不良生存结局之间的关联长期以来一直令人悲观。然而,达马尔·哈姆林先生公开见证的心脏骤停、复苏及急性处理过程,以及他良好的神经功能恢复,带来了一些乐观的因素。哈姆林先生的病例凸显了过去20年的神经学进展,并为改善所有心脏骤停患者在关键领域的结局提供了契机:(1)有效实施美国心脏协会的“生存链”以预防初始脑损伤并促进神经保护;(2)重新审视神经预后评估过程并重新定义早期的脑恢复情况;(3)将神经康复纳入现有的心脏康复模式以支持整体恢复。《神经病学年鉴》2023年;93卷:871 - 876页。