Letter Re: Practice guideline summary: Reducing brain injury following cardiopulmonary resuscitation: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology

We read with interest the article by Geocadin et al.1 and found the conclusion of importance. Over the last 2 years, we observed a group of 32 patients treated with mild therapeutic hypothermia after an out-of-hospital nontraumatic cardiac arrest. When considering the effect of the cardiac arrest on the patients' subsequent outcomes in the short and middle term, a sharp difference between 2 conditions was observed. A cardiac arrest complicated by a not-shockable rhythm and a circulatory instability is usually accompanied by a worsening cerebral edema. These 2 signs, clearly connected to each other, are strong predictors of short survival and of poor neurologic outcome, independent from any treatment. On the contrary, in the case of cardiac arrest followed by a shockable rhythm, mild therapeutic hypothermia is directly indicated for the greater possibility of a good outcome.2–4 In these patients, any early invasive treatment of the acute cardiac pathology, or of any other intervening complication, is not contraindicated.
Source: Neurology - Category: Neurology Authors: Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research