• Gavin D Perkins, Clifton W Callaway, Kirstie Haywood, Robert W Neumar, Gisela Lilja, Matthew J Rowland, Kelly N Sawyer, Markus B Skrifvars, and Jerry P Nolan.
• Warwick Medical School, University of Warwick, Coventry, UK; Critical Care Unit, University Hospitals Birmingham, Birmingham, UK. Electronic address: g.d.perkins@warwick.ac.uk.
• Lancet. 2021 Oct 2; 398 (10307): 1269-1278.

AbstractAs more people are surviving cardiac arrest, focus needs to shift towards improving neurological outcomes and quality of life in survivors. Brain injury after resuscitation, a common sequela following cardiac arrest, ranges in severity from mild impairment to devastating brain injury and brainstem death. Effective strategies to minimise brain injury after resuscitation include early intervention with cardiopulmonary resuscitation and defibrillation, restoration of normal physiology, and targeted temperature management. It is important to identify people who might have a poor outcome, to enable informed choices about continuation or withdrawal of life-sustaining treatments. Multimodal prediction guidelines seek to avoid premature withdrawal in those who might survive with a good neurological outcome, or prolonging treatment that might result in survival with severe disability. Approximately one in three admitted to intensive care will survive, many of whom will need intensive, tailored rehabilitation after discharge to have the best outcomes.Copyright © 2021 Elsevier Ltd. All rights reserved.

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