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guidelines·critical care, emergency medicine, cardiology, neurology, pulmonology·PMC10861627

Critical Care Management of Patients After Cardiac Arrest: A Scientific Statement from the American Heart Association and Neurocritical Care Society

Neurocritical Care · 24 authors, 24 centres

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FIDELITY 100%

This summary was generated by AI from a single paper. It has not been reviewed by a clinician and is not clinical advice. Verify against the source before acting on it.

AGENT 01 · STRUCTURED SUMMARY

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TL;DR

It uses a modified Delphi process among experts to address the wide variation in clinical practice due to a paucity of strong evidence.

Full summary

622 CHARS

The central result is the development of consensus statements to standardize care, as current guidelines have few strong recommendations due to limited evidence certainty. The statement explicitly does not make formal recommendations but presents statements reflecting the degree of panel agreement. Key limitations include the reliance on expert opinion for some topics, the potential for bias in the consensus process, and the acknowledgment that not all referenced care may be available everywhere. The implications are to guide interdisciplinary care for CA survivors while highlighting areas where evidence is needed.

STUDY TYPE

guidelines

SPECIALTY

critical care

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10861627

Critical Care Management of Patients After Cardiac Arrest: A Scientific Statement from the American Heart Association and Neurocritical Care Society

Neurocritical Care

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ABSTRACT

Abstract The critical care management of patients after cardiac arrest is burdened by a lack of high-quality clinical studies and the resultant lack of high-certainty evidence. This results in limited practice guideline recommendations, which may lead to uncertainty and variability in management. Critical care management is crucial in patients after cardiac arrest and affects outcome. Although guidelines address some relevant topics (including temperature control and neurological prognostication of comatose survivors, 2 topics for which there are more robust clinical studies), many important subject areas have limited or nonexistent clinical studies, leading to the absence of guidelines or low-certainty evidence. The American Heart Association Emergency Cardiovascular Care Committee and the Neurocritical Care Society collaborated to address this gap by organizing an expert consensus panel and conference. Twenty-four experienced practitioners (including physicians, nurses, pharmacists, and a respiratory therapist) from multiple medical specialties, levels, institutions, and countries made up the panel. Topics were identified and prioritized by the panel and arranged by organ system to facilitate discussion, debate, and consensus building. Statements related to postarrest management were generated, and 80% agreement was required to approve a statement. Voting was anonymous and web based. Topics addressed include neurological, cardiac, pulmonary, hematological, infectious, gastrointestinal, endocrine, and general critical care management. Areas of uncertainty, areas for which no consensus was reached, and future research directions are also included. Until high-quality studies that inform practice guidelines in these areas are available, the expert panel consensus statements that are provided can advise clinicians on the critical care management of patients after cardiac arrest. Keywords: AHA scientific statements; Critical care; Heart arrest; Hypoxia–ischemia, brain; Resuscitation; Shock, cardiogenic

CITATION EXPORT

Karen G Hirsch, Benjamin S Abella, Edilberto Amorim et al.. Critical Care Management of Patients After Cardiac Arrest: A Scientific Statement from the American Heart Association and Neurocritical Care Society. Neurocritical Care. (2023). https://doi.org/10.1007/s12028-023-01871-6

AUTHORS

24 · 24 CENTRES

Karen G Hirsch, Benjamin S Abella, Edilberto Amorim, Mary Kay Bader, Jeffrey F Barletta, Katherine Berg, Clifton W Callaway, Hans Friberg, Emily J Gilmore, David M Greer, Karl B Kern, Sarah Livesay, Teresa L May, Robert W Neumar, Jerry P Nolan, Mauro Oddo, Mary Ann Peberdy, Samuel M Poloyac, David Seder, Fabio Silvio Taccone, Anezi Uzendu, Brian Walsh, Janice L Zimmerman, Romergryko G Geocadin

1Stanford University, Stanford, USA
2University of Pennsylvania, Philadelphia, USA
3San Francisco–Weill Institute for Neurosciences, University of California, San Francisco, USA
4Providence Mission Hospital Nursing Center of Excellence/Critical Care Services, Mission Viejo, USA
5Midwestern University, Downers Grove, USA
6Beth Israel Deaconess Medical Center, Boston, USA
7University of Pittsburgh, Pittsburgh, USA
8Skane University Hospital, Malmö, Sweden
9Yale University School of Medicine, New Haven, USA
10Boston University School of Medicine, Boston, USA
11Sarver Heart Center, University of Arizona, Tucson, USA
12Rush University College of Nursing, Chicago, USA
13Maine Medical Center, Portland, USA
14University of Michigan, Ann Arbor, USA
15Warwick Medical School, University of Warwick, Coventry, UK
16Royal United Hospital, Bath, UK
17CHUV-Lausanne University Hospital, Lausanne, Switzerland
18Virginia Commonwealth University, Richmond, USA
19University of Texas at Austin, Austin, USA
20Hopital Universitaire de Bruxelles, Brussels, Belgium
21St. Luke’s Mid America Heart Institute, Kansas City, USA
22University of Texas Medical Branch School of Health Sciences, Galveston, USA
23The Methodist Hospital Physician Organization, Houston, USA
24Johns Hopkins University School of Medicine, Baltimore, USA