Open AccessThe first national survey on practices of neurological prognostication after cardiac arrest in China, still a lot to do
Author(s) -
Du Lanfang,
Zheng Kang,
Feng Lu,
Cao Yu,
Niu Zhendong,
Song Zhenju,
Liu Zhi,
Liu Xiaowei,
Xiang Xudong,
Zhou Qidi,
Xiong Hui,
Chen Fengying,
Zhang Guoqiang,
Ma Qingbian
Publication year - 2021
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.13759
Subject(s) - medicine , status epilepticus , somatosensory evoked potential , electroencephalography , neurological examination , clinical practice , emergency medicine , intensive care medicine , pediatrics , physical therapy , anesthesia , psychiatry , epilepsy
Aims To investigate current awareness and practices of neurological prognostication in comatose cardiac arrest (CA) patients. Methods An anonymous questionnaire was distributed to 1600 emergency physicians in 75 hospitals which were selected randomly from China between January and July 2018. Results 92.1% respondents fulfilled the survey. The predictive value of brain stem reflex, motor response and myoclonus was confirmed by 63.5%, 44.6% and 31.7% respondents, respectively. Only 30.7% knew that GWR value < 1.1 indicated poor prognosis and only 8.1% know the most commonly used SSEP N20. Status epilepticus, burst suppression and suppression were considered to predict poor outcome by only 35.0%, 27.4% and 20.9% respondents, respectively. Only 46.7% knew NSE and only 24.7% knew S‐100. Only a few respondents knew that neurological prognostication should be performed later than 72 hours from CA either in TTM or non‐TTM patients. In practice, the most commonly used method was clinical examination (85.4%). Only 67.9% had used brain CT for prognosis and 18.4% for MRI. NSE (39.6%) was a little more widely used than S‐100β (18.0%). However, SSEP (4.4%) and EEG (11.4%) were occasionally performed. Conclusions Neurological prognostication in CA survivors had not been well understood and performed by emergency physicians in China. They were more likely to use clinical examination rather than objective tools, especially SSEP and EEG, which also illustrated that multimodal approach was not well performed in practice.