Neuroprognostication after Cardiac Arrest

In this episode of Critical Matters, Dr. Sergio Zanotti interviews Dr. Fred Rincon about neurological prognostication after cardiac arrest. Dr. Rincon emphasizes the importance of not rushing to conclusions due to advances in resuscitation medicine and temperature management. The discussion covers physical findings, biochemical tests like NSE, electrophysiological studies (SSEPs and EEG), and neuroimaging, highlighting the significance of timing and a multimodality approach. Dr. Rincon stresses the value of the clinical exam and EEG reactivity, while cautioning against relying solely on biomarkers or imaging. They discuss the timing of neuroprognostication, recommending a 72-hour waiting period post-rewarming before implementing assessment tools. The episode concludes with Dr. Rincon's preferred tools for neuroevaluation and a brief discussion on ethical considerations in critical care.