Neuroprognostication after Cardiac Arrest

In this episode of Critical Matters, Dr. Sergio Zanotti interviews Dr. Neha Dangayach, a Neurocritical Care Physician, about best practices in neuroprognostication after cardiac arrest. They discuss the historical context of neuroprognostication, the impact of therapeutic temperature management (TTM), and the importance of a multimodal approach. Dr. Dangayach emphasizes diagnostic humility, the significance of timing in evaluations, and the need to consider confounding factors like sedatives and organ failures. They delve into the role of physical exams, biochemical tests like neuron-specific enolase (NSE), electrophysiological tests such as EEG and SSEPs, and brain imaging (CT scans and MRIs) in determining prognosis. The conversation also covers common pitfalls to avoid, such as self-fulfilling prophecies and misinterpretations of studies, and concludes with Dr. Dangayach sharing influential books and personal beliefs.