• G Geri, N Mongardon, F Daviaud, J-P Empana, F Dumas, and A Cariou.
• Medical Intensive Care Unit, Cochin Hospital, Assistance publique des Hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Faculté de médecine, université Paris Descartes & Sorbonne Paris Cité, 15, rue de l'École-de-Médecine, 75006 Paris, France; Paris Cardiovascular Research Center, European Georges-Pompidou Hospital, INSERM U970, 56, rue Leblanc, 75015 Paris, France.
• Ann Fr Anesth Reanim. 2014 Feb 1; 33 (2): 98-101.

AbstractWith increasing public education in basic life support and with the widespread use of automated defibrillators, post-cardiac arrest comatose patients represent a growing part of ICU admissions. However the prognosis remains very poor and only a very low proportion of these resuscitated patients will recover and will leave the hospital without major neurological impairments. Neurological dysfunction predominantly includes disorders of consciousness, and may also include other manifestations such as seizures, myoclonus status epilepticus and other forms of movement disorders including post-anoxic myoclonus. In the most severe cases, coma may be irreversible or evolve towards a minimally conscious state, a vegetative state or even brain death. These severe conditions represent by far the leading cause of mortality and disability in such patients. Currently, early use of mild therapeutic hypothermia is the only treatment that demonstrated its ability to decrease neurological consequences and to improve the prognosis. Prognostication outcome is still mainly based on a rigorous clinical evaluation coupled with neuro-physiological investigations, but brain functional imaging could become a valuable tool in the near future. Clinical research focusing on survivors should be strongly encouraged in order to assess the mid- and long-terms outcome of survivors and to evaluate the impact of new treatments or strategies. Copyright © 2013 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

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