Iavarone Ida Giorgia, Donadello Katia, Cammarota Giammaria, D'Agostino Fausto, Pellis Tommaso, Roman-Pognuz Erik, Sandroni Claudio, Semeraro Federico, Sekhon Mypinder, Rocco Patricia R M, Robba Chiara
Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genova, Italy.
Department of Surgery, Anaesthesia and Intensive Care Unit B, Dentistry, Paediatrics and Gynaecology, University of Verona, University Hospital Integrated Trust of Verona, Verona, Italy.
Interface Focus. 2024 Dec 6;14(6):20240025. doi: 10.1098/rsfs.2024.0025.
Cardiac arrest (CA) is associated with high incidence and mortality rates. Among patients who survive the acute phase, brain injury stands out as a primary cause of death or disability. Effective intensive care management, including targeted temperature management, seizure treatment and maintenance of normal physiological parameters, plays a crucial role in improving survival and neurological outcomes. Current guidelines advocate for neuroprotective strategies to mitigate secondary brain injury following CA, although certain treatments remain subjects of debate. Clinical examination and neuroimaging studies, both invasive and non-invasive neuromonitoring methods and serum biomarkers are valuable tools for predicting outcomes in comatose resuscitated patients. Neuromonitoring, in particular, provides vital insights for identifying complications, personalizing treatment approaches and forecasting prognosis in patients with brain injury post-CA. In this review, we offer an overview of advanced strategies and best practices aimed at optimizing brain protection after CA.
心脏骤停（CA）的发病率和死亡率都很高。在急性期存活的患者中，脑损伤是导致死亡或残疾的主要原因。有效的重症监护管理，包括目标温度管理、癫痫治疗和维持正常生理参数，对提高生存率和神经功能结局起着至关重要的作用。目前的指南提倡采取神经保护策略以减轻心脏骤停后的继发性脑损伤，尽管某些治疗方法仍存在争议。临床检查、神经影像学研究、有创和无创神经监测方法以及血清生物标志物都是预测昏迷复苏患者预后的重要工具。特别是神经监测，为识别心脏骤停后脑损伤患者的并发症、个性化治疗方案和预测预后提供了重要见解。在本综述中，我们概述了旨在优化心脏骤停后脑保护的先进策略和最佳实践。
