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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
identiļ¬cation 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.