Current opinion in critical care
-
The ANDROMEDA-SHOCK trial positioned capillary refill time (CRT) assessment as a novel resuscitation target for septic shock.The purpose of this article is to summarize pathophysiological determinants of CRT, review new technical developments on peripheral perfusion assessment, and explore recent evidence on the role of CRT monitoring in septic shock and other critical conditions. ⋯ Recent data confirm the relevance of peripheral perfusion assessment in septic shock and other conditions in critically ill patients. Future studies should confirm these findings, and test the potential contribution of technological devices to assess peripheral perfusion.
-
This review considers the latest evidence relating to the epidemiology and outcomes, treatment guidelines, diagnostic and therapeutic interventions in traumatic cardiac arrest. ⋯ Trauma related cardiac arrest differs from cardiac arrest due to medical causes. Whilst the core principles of treatment are similar, a higher priority is placed on identifying and treating reversible causes.
-
Curr Opin Crit Care · Jun 2023
ReviewThe role of the electroencephalogram and evoked potentials after cardiac arrest.
In comatose cardiac arrest survivors, the electroencephalogram (EEG) is the most widely used test to assess the severity of hypoxic-ischemic brain injury (HIBI) and guide antiseizure treatment. However, a wide variety of EEG patterns are described in literature. Moreover, the value of postarrest seizure treatment is uncertain. Absent N20 waves of short-latency somatosensory-evoked potentials (SSEPs) are a specific predictor of irreversible HIBI. However, the prognostic significance of the N20 amplitude is less known. ⋯ Standardized EEG terminology and quantitative approach to SSEP are promising for improving the neuroprognostic accuracy of these tests. Further research is needed to identify the potential benefits of antiseizure treatment after cardiac arrest.