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IntroductionCardiac arrest (CA) is a major healthy concern worldwide.1 Most patients who survive to hospital after return of spontaneous circulation (ROSC) are still comatose in the first few days or weeks.2 Therefore, neurological prognostication has become a very important part of post-CA care. Early and accurate prediction of neurological outcome should allow optimizing identification of those individuals with no chance of a good recovery and avoid making inappropriate decisions to withdrawal of life support in patients who had the potential for recovery which is a frequent cause of death in the ICU.3,4
It remains challenging to differentiate patients who may recover from those who cannot, despite the emerging of numerous ancillary tests. The prognostic tools that are commonly used in practice include clinical examination, electrophysiological measurements, biomarkers and neuroimaging.5,6 There is no single test to reliably predict outcome. A multimodal diagnostic algorithm was currently recommended to minimize prognostic uncertainty. 5,6The best time point for initiating the process of neurological evaluation was unknown. Current guidelines recommend it should not be performed before 72h from ROSC, especially in the ear of target temperature management (TTM).6 Both TTM itself and sedatives or muscle relaxant agents used to maintain it may weaken predictive value of prognostic indexes. So prolonging examination was suggested in cooling patients, ensuring the clearance of confounders.
For providing guidance for future work, it would be very important to understand the current problems of neurological prognostication for CA survivors in China. However, to our best knowledge, no study has to date evaluated this situation. The national survey was therefore conducted to give an overview of current awareness and practice of post CA neurological evaluation in China focusing on large university affiliated hospitals or university teaching hospitals which are key opinion leaders in this field.