Abstract
During the last two decades, survival rates after cardiac arrest have increased while
the fraction of patients surviving with a severe neurological disability or vegetative
state has decreased in many countries. While improved survival is due to improvements
in the whole “chain of survival,” improved methods for prognostication of neurological
outcome may be of major importance for the lower disability rates. Patients who are
resuscitated and treated in intensive care will die mainly from the withdrawal of
life-sustaining (WLST) therapy due to presumed poor chances of meaningful neurological
recovery. To ensure high-quality decision-making and to reduce the risk of premature
withdrawal of care, implementation of local protocols is crucial and should be guided
by international recommendations. Despite rigorous neurological prognostication, cognitive
impairment and related psychological distress and reduced participation in society
will still be relevant concerns for cardiac arrest survivors. The commonly used outcome
measures are not designed to provide information on these domains. Follow-up of the
cardiac arrest survivor needs to consider the cardiovascular burden as an important
factor to prevent cognitive difficulties and future decline.
Keywords
cardiac arrest - coma - prognosis - outcome
