Cognitive decline after cardiac arrest – It is more to the picture than hypoxic brain injury

Cronberg, Tobias; Lilja, Gisela

doi:10.1016/j.resuscitation.2015.03.002

Cited by 10 publications

(6 citation statements)

References 17 publications

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“…33,34 The increased possibility of cognitive impairment and early death for CA survivors needs to be taken into account, and multidisciplinary programmes need to be developed in order to support this group of survivors and help them adjust to their new reality. 35 Although research indicates a need for increased psychological support after a CA in order to improve survivors’ QOL, 34 there is as yet no clear clinical pathway from hospital care to community care that specifically targets the psychological issues that occur after surviving a CA. The feasibly of an assigned ‘mentor’ nurse who could give the survivor a personal connection and continuity through the hospital, rehabilitation and home transfer could be considered, providing better communication between care teams.…”

Section: Discussionmentioning

confidence: 99%

A systematic review and meta-synthesis of the qualitative literature exploring the experiences and quality of life of survivors of a cardiac arrest

Haydon

Riet

Inder

2017

European Journal of Cardiovascular Nursing

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Background: Survival following cardiac arrest and subsequent cardiopulmonary resuscitation (CPR) is increasing worldwide, mainly due to greater awareness of the symptoms of cardiac events and an increased attention to CPR training. Although patient outcomes remain unpredictable and quantitative studies suggest that the overall quality of life (QOL) is acceptable, it is valuable to synthesise qualitative studies exploring these phenomena in depth, providing a deeper knowledge of survivors' experiences and QOL. Aims: To critically appraise and synthesise the qualitative literature on survivors' experiences of a cardiac arrest and CPR with the aim of identifying common themes that can inform clinical pathways and thereby improve survivor outcomes and QOL. Methods: A systematic review and meta-synthesis of the qualitative literature, using Thomas and Harden's framework, and confined to peer-reviewed papers published from 2000 to 2015, which were identified through database searches of EBSCO, OVID and ProQuest. Results: The search produced 204 papers, and of these, seven relevant papers were identified for review. Data extraction included setting, participants, research design, data collection, analysis and themes. Five qualitative themes were identified and were the subject of this meta-synthesis: multitude of contrasting feelings; disruption in the continuum of time; new reality and psychological challenges; changed body with new limitations; and confrontation with death. Conclusion: This review provides insights into the experiences of survivors' QOL after CPR. Increased knowledge can improve person-centred care in the immediate and forthcoming care after the event, both in terms of planning for discharge and in the future care of people who survive a cardiac arrest.

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Section: Discussionmentioning

confidence: 99%

A systematic review and meta-synthesis of the qualitative literature exploring the experiences and quality of life of survivors of a cardiac arrest

Haydon

Riet

Inder

2017

European Journal of Cardiovascular Nursing

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“…Most studies of cognitive dysfunction after cardiac arrest have focused on hypoxic/ischemic mechanism, while the contribution of cardiovascular disease to cognitive dysfunction has been relatively overlooked in OHCA survivors (Cronberg and Lilja, 2015). Cardiovascular disease, a risk factor for cardiac arrest, is well known to be associated with cognitive function (Irani et al, 2009;Jefferson et al, 2011;Cronberg and Lilja, 2015), however, few studies have included a cardiovascular control group when examining the neurophysiological and cognitive outcomes in cardiac arrest survivors (Grubb et al, 2000;Stamenova et al, 2018). In the largest known study of cognitive outcomes after cardiac arrest (Lilja et al, 2015), decreased memory performance was observed not only in the cardiac arrest group but also in the myocardial infarction (MI) group that had not experienced an arrest.…”

Section: Introductionmentioning

confidence: 99%

Exploratory Analyses of Cerebral Gray Matter Volumes After Out-of-Hospital Cardiac Arrest in Good Outcome Survivors

et al. 2020

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Background: Survival rates of cardiac arrest have increased over recent years, however, survivors may still be left with significant morbidity and functional impairment. A primary concern in cardiac arrest survivors is the effect of prolonged hypoxia/ischemia on the brain. The objectives of the present study were threefold: (1) to explore the effect of cardiac arrest on brain gray matter volumes (GMV) in "good outcome" survivors of out-of-hospital cardiac arrest (OHCA), (2) to examine the relationship between GMV, cognitive functioning and arrest factors, and (3) to explore whether OHCA patients differ from a group of patients with myocardial infarction (MI) uncomplicated by cardiac arrest and a group of healthy controls in terms of GMV. Methods: Medically stable OHCA survivors with preserved neurological function and who were eligible for magnetic resonance imaging scanning (MRI; n = 9), were compared to: (1) patients who had experienced a MI (n = 19) and (2) healthy controls (n = 12). Participants underwent brain MRI on a 3T Siemens Trio MRI scanner and GMV was measured by voxel-based morphometry. A comprehensive neuropsychological assessment was also conducted. Global GMV was compared in the three samples using analyses of variance. The relationships between cognition and GMV were examined within group using correlations. Results: The OHCA and MI groups showed a similar pattern of differences compared to the healthy control group. Both groups had decreased GMV in the anterior cingulate cortex, bilateral hippocampus, right dorsolateral prefrontal cortex, right putamen, and bilateral cerebellum. There were no significant differences in global or regional GMV between the OHCA and MI groups. Cognitive functioning was correlated with global GMV in the OHCA group; no such correlation was observed in the MI group. Conclusion: Regional atrophy was observed in OHCA and MI survivors, compared to a healthy control group, suggesting a common mechanism, presumably preexisting cardiovascular disease. Although similar regional volume differences were observed between the MI and OHCA groups, the relationship between GMV and cognition was

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“…Since cardiac etiology is common [ 2 ], CA survivors are likely to receive cardiovascular follow-up, primarily focused on physiological secondary prevention [ 20 ]. However, because they are at risk of also suffering neurological and emotional complications [ 5 , 6 ], which might affect their QoL [ 10 ], specific care and follow-up is necessary [ 6 , 21 – 23 ]. Previous research describing specific post CA care and follow-up is sparse [ 24 – 27 ].…”

Section: Introductionmentioning

confidence: 99%

Post cardiac arrest care and follow-up in Sweden – a national web-survey

et al. 2016

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BackgroundRecent decades have shown major improvements in survival rates after cardiac arrest. However, few interventions have been tested in order to improve the care for survivors and their family members. In many countries, including Sweden, national guidelines for post cardiac arrest care and follow-up programs are not available and current practice has not previously been investigated. The aim of this survey was therefore to describe current post cardiac arrest care and follow-up in Sweden.MethodsAn internet based questionnaire was sent to the resuscitation coordinators at all Swedish emergency hospitals (n = 74) and 59 answers were received. Quantitative data were analysed with descriptive statistics and free text responses were analysed using manifest content analysis.ResultsAlmost half of the hospitals in Sweden (n = 27, 46 %) have local guidelines for post cardiac arrest care and follow-up. However, 39 % of them reported that these guidelines were not always applied. The most common routine is a follow-up visit at a cardiac reception unit. If the need for neurological or psychological support are discovered the routines are not explicit. In addition, family members are not always included in the follow-up.ConclusionsAlthough efforts are already made to improve post cardiac arrest care and follow-up, many hospitals need to focus more on this part of cardiac arrest treatment. In addition, evidence-based national guidelines will have to be developed and implemented in order to achieve a more uniform care and follow-up for survivors and their family members. This national survey highlights this need, and might be helpful in the implementation of such guidelines.Electronic supplementary materialThe online version of this article (doi:10.1186/s12912-016-0123-0) contains supplementary material, which is available to authorized users.

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Cognitive decline after cardiac arrest – It is more to the picture than hypoxic brain injury

Cited by 10 publications

References 17 publications

A systematic review and meta-synthesis of the qualitative literature exploring the experiences and quality of life of survivors of a cardiac arrest

A systematic review and meta-synthesis of the qualitative literature exploring the experiences and quality of life of survivors of a cardiac arrest

Exploratory Analyses of Cerebral Gray Matter Volumes After Out-of-Hospital Cardiac Arrest in Good Outcome Survivors

Post cardiac arrest care and follow-up in Sweden – a national web-survey

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