Cardiac Arrest and Neurologic Recovery: Insights from the Case of Mr. Damar Hamlin

Abstract

The association between brain injury after cardiac arrest and poor survival outcomes has led to longstanding pessimism. However, the publicly witnessed cardiac arrest, resuscitation, and acute management of Mr. Damar Hamlin and his favorable neurologic recovery provides some optimism. Mr. Hamlin's case highlights the neurologic advances of the last 2 decades and presents the opportunity to improve outcomes for all cardiac arrest patients in key areas: (1) effectively implementing the American Heart Association “Chain of Survival” to prevent initial brain injury and promote neuroprotection; (2) revisiting the process of neurologic prognostication and re‐defining the brain recovery during the early periods, and (3) incorporating neurorehabilitation into existing cardiac rehabilitation models to support holistic recovery. ANN NEUROL 2023;93:871–876

Neuroprotective–Neurorestorative Effects Induced by Progesterone on Global Cerebral Ischemia: A Narrative Review

“…Consequently, the therapeutic intervention with progesterone to promote neurorestoration could be investigated within a considerably broader time frame, spanning at least several months post-ischemia [53,54], in contrast to the more limited timeframe typically considered for the neuroprotective approach [44,45]. The exploration and analysis of treatments targeting neurorehabilitation are crucial [99,100], as numerous treatments focused solely on neuroprotection have proven ineffective in clinical trials [45][46][47][48]. Morphofunctional effects of progesterone (P4) treatment against an episode of global cerebral ischemia.…”

An Update on Brain Death/Death by Neurologic Criteria since the World Brain Death Project

“…32 There are also other publications that cited the WBDP's description of the minimum clinical criteria for BD/DNC determination as the reference standard and reinforced the message that BD/DNC is first and foremost a clinical assessment, and while nearly all of them refer to human patients, there is one case report on resuscitation of a dog after OHCA that mentioned the WBDP prescribes the need for observation prior to consideration of BD/DNC evaluation after HIBI. [99][100][101][102][103][104][105][106][107][108] New Publications Related to the Prerequisites for BD/DNC Determination Since publication of the WBDP, there have been a few publications on the prerequisites for BD/DNC evaluation including pharmacological and laboratory confounders and the requisite observation period. 4,32,[109][110][111][112][113] In a 2023 narrative review, Kanji et al expanded on the WBDP's guidance on pharmacological confounders to BD/DNC evaluation.…”

“…32 There are also other publications that cited the WBDP's description of the minimum clinical criteria for BD/DNC determination as the reference standard and reinforced the message that BD/DNC is first and foremost a clinical assessment, and while nearly all of them refer to human patients, there is one case report on resuscitation of a dog after OHCA that mentioned the WBDP prescribes the need for observation prior to consideration of BD/DNC evaluation after HIBI. 99 100 101 102 103 104 105 106 107 108…”