Brain Tissue Survival and Prognosis After Cardiac Arrest

Post-Arrest Care and Prognostic Indicators

• Post-cardiac arrest brain injury manifests as coma, seizures, myoclonus, varying degrees of neurocognitive dysfunction, and brain death, according to the Intensive Care Medicine guidelines 1
• Bilateral absence of pupillary light reflex at 72 hours predicts poor outcome with 0% false positive rate, as stated by the Circulation guidelines 2
• Status myoclonus within 72-120 hours predicts poor outcome with 0% false positive rate, as reported by the Circulation guidelines 3
• Avoid hyperventilation post-arrest, as hypocapnia causes cerebral vasoconstriction and may worsen ischemia, according to the Circulation guidelines 4
• Prevent hyperoxia, as arterial oxygen saturation should be maintained at 94-96%, not 100%, as hyperoxemia may worsen neuronal injury, recommended by the Intensive Care Medicine and Circulation guidelines 1, 4