In this episode of The Internet Book of Critical Care Podcast, Josh Farkas and Adam Thomas discuss neuroprognostication after cardiac arrest, emphasizing its importance in critical care for avoiding both premature withdrawal of life-sustaining therapy and prolonging care unnecessarily. They explore the history of neuroprognostication, the impact of hypothermia, and the significance of timing in neurological assessments. The discussion covers confounding factors like therapeutic hypothermia and medications, the value of neurological exams, EEG, structural tests like CT and MRI, and the potential of biomarkers like neurofilament light chain. They stress the importance of clear communication with families, shared decision-making, and a structured approach to neurological assessments to balance the priorities of patient outcomes and quality of life.
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