Brain injury after cardiac arrest: pathophysiology, treatment, and prognosis

Claudio Sandroni; Tobias Cronberg; Mypinder Sekhon

doi:10.1007/s00134-021-06548-2

Brain injury after cardiac arrest: pathophysiology, treatment, and prognosis

Intensive Care Med. 2021 Dec;47(12):1393-1414. doi: 10.1007/s00134-021-06548-2. Epub 2021 Oct 27.

Authors

Claudio Sandroni^{1

2}, Tobias Cronberg³, Mypinder Sekhon⁴

Affiliations

¹ Institute of Anaesthesiology and Intensive Care Medicine, Università Cattolica del Sacro Cuore, Rome, Italy. claudio.sandroni@policlinicogemelli.it.
² Department of Intensive Care, Emergency Medicine and Anaesthesiology, Fondazione Policlinico Universitario "Agostino Gemelli", IRCCS, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy. claudio.sandroni@policlinicogemelli.it.
³ Department of Clinical Sciences Lund, Neurology, Lund University, Skåne University Hospital, Lund, Sweden.
⁴ Division of Critical Care Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.

Abstract

Post-cardiac arrest brain injury (PCABI) is caused by initial ischaemia and subsequent reperfusion of the brain following resuscitation. In those who are admitted to intensive care unit after cardiac arrest, PCABI manifests as coma, and is the main cause of mortality and long-term disability. This review describes the mechanisms of PCABI, its treatment options, its outcomes, and the suggested strategies for outcome prediction.

Keywords: Brain; Cardiac arrest; Coma; EEG; Hypoxia-Ischemia; Prognostication.

Publication types

Review

MeSH terms

Brain Injuries*
Cardiopulmonary Resuscitation*
Coma / etiology
Coma / therapy
Heart Arrest* / therapy
Humans
Prognosis