The interpretation of American Academy of Neurology clinical practice guideline on reducing brain injury following cardiopulmonary resuscitation in 2017_Chinese Journal of Evidence-Based Medicine

Authors：

 YANG Min ^1,2 , WANG Min ^1,2 , LI Hui ^1,2 , HUA Tianfeng ^1,2 , ZHENG Yao ^1,2

1. The Laboratory of Cardiopulmonary Resuscitation and Critical Care Medicine, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, P.R.China;
2. Department of Intensive Care Unit, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, P.R.China;

Corresponding author：

YANG Min, Email: 512130761@qq.com

Keywords：

Cardiopulmonary resuscitation (CPR); Brain injury; Clinical practice guideline; Guideline interpretation; American Academy of Neurology (AAN)

DOI：

10.7507/1672-2531.201711030

Video：

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Brain injury after cardiopulmonary resuscitation is closely related to the survival rate and prognosis of neurological function of cardiac arrest (CA) patients. Recently, the American Academy of Neurology (AAN) published a practice guideline which had updated the evaluation of different treatments for reducing brain injury following cardiopulmonary resuscitation. In order to master and transmit AAN 2017 practice guideline on reducing brain injury following cardiopulmonary resuscitation, this paper interprets the new AAN clinical practice guideline to assist Chinese clinicians for better studying the guideline.

Citation： YANG Min, WANG Min, LI Hui, HUA Tianfeng, ZHENG Yao. The interpretation of American Academy of Neurology clinical practice guideline on reducing brain injury following cardiopulmonary resuscitation in 2017. Chinese Journal of Evidence-Based Medicine, 2018, 18(2): 125-129. doi: 10.7507/1672-2531.201711030 Copy

1.	Geocadin RG, Wijdicks E, Armstrong MJ, et al. Practice guideline summary: reducing brain injury following cardiopulmonary resuscitation: report of the guideline development, dissemination, and implementation subcommittee of the American Academy of Neurology. Neurology, 2017, 88(22): 2141-2149.
2.	Nielsen N, Wetterslev J, Cronberg T, et al. Targeted temperature management at 33℃ versus 36℃ after cardiac arrest. N Engl J Med, 2013, 369 (23): 2197-2206.
3.	Callaway CW, Donnino MW, Fink EL, et al. Part 8: Post-cardiac arrest care: 2015 American heart association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation, 2015, 132(18 Suppl 2): S465-482.
4.	Kim F, Nichol G, Maynard C, et al. Effect of prehospital induction of mild hypothermia on survival and neurological status among adults with cardiac arrest: a randomized clinical trial. JAMA, 2014, 311(1): 45-52.
5.	Castrén M, Nordberg P, Svensson L, et al. Intra-arrest transnasal evaporative cooling: a randomized, prehospital, multicenter study (PRINCE: Pre-ROSC IntraNasal Cooling Effectiveness). Circulation, 2010, 122(7): 729-736.
6.	Bernard SA, Smith K, Cameron P, et al. Induction of therapeutic hypothermia by paramedics after resuscitation from out-of-hospital ventricular fibrillation cardiac arrest: a randomized controlled trial. Circulation, 2010, 122(7): 737-742.
7.	Bernard SA, Smith K, Cameron P, et al. Induction of prehospital therapeutic hypothermia after resuscitation from nonventricular fibrillation cardiac arrest. Crit Care Med, 2012, 40(3): 747-753.
8.	Kämäräinen A, Virkkunen I, Tenhunen J, et al. Prehospital therapeutic hypothermia for comatose survivors of cardiac arrest: a randomized controlled trial. Acta Anaesthesiol Scand, 2009, 53(7): 900-907.
9.	Debaty G, Maignan M, Savary D, et al. Impact of intra-arrest therapeutic hypothermia in outcomes of prehospital cardiac arrest: a randomized controlled trial. Intensive Care Med, 2014, 40(12): 1832-1842.
10.	Pittl U, Schratter A, Desch S, et al. Invasive versus non-invasive cooling after in and out of hospital cardiac arrest: a randomized trial. Clin Res Cardiol, 2013, 102(8): 607-614.
11.	de Waard MC, Biermann H, Brinckman SL, et al. Automated peritoneal lavage: an extremely rapid and safe way to induce hypothermia in post-resuscitation patients. Crit Care, 2013, 17(1): R31.
12.	Hollenbeck RD, Wells Q, Pollock J, et al. Implementation of a standardized pathway for the treatment of cardiac arrest patients using therapeutic hypothermia: "CODE ICE". Crit Pathw Cardiol, 2012, 11(3): 91-98.
13.	Damian MS, Ellenberg D, Gildemeister R, et al. Coenzyme Q10 combined with mild hypothermia after cardiac arrest: a preliminary study. Circulation, 2004, 110(19): 3011-3016.
14.	Laitio R, Hynninen M, Arola O, et al. Effect of inhaled xenon on cerebral white matter damage in comatose survivors of out-of-hospital cardiac arrest: a randomized clinical trial. JAMA, 2016, 315(11): 1120-1128.
15.	Roine RO, Kaste M, Kinnunen A, et al. Nimodipine after resuscitation from out-ofhospital ventricular fibrillation: a placebo-controlled, double-blind, randomized trial. JAMA, 1990, 264(24): 3171-3177.
16.	Brain Resuscitation Clinical Trial II Study Group. A randomized clinical study of a calcium-entry blocker (lidoflazine) in the treatment of comatose survivors of cardiac arrest. N Engl J Med, 1991, 324(18): 1225-1231.
17.	Reisinger J, Höllinger K, Lang W, et al. Does early administration of selenium improve neurological outcome after cardiac arrest? Am J Emerg Med, 2009, 27(2): 176-181.
18.	Brain Resuscitation Clinical Trial I Study Group. Randomized clinical study of thiopental loading in comatose survivors of cardiac arrest. N Engl J Med, 1986, 314(7): 397-403．.
19.	Longstreth WT Jr, Fahrenbruch CE, Olsufka M, et al. Randomized clinical trial of magnesium, diazepam, or both after out-of-hospital cardiac arrest. Neurology, 2002, 59(4): 506-514.
20.	Jastremski M, Sutton-Tyrrell K, Vaagenes P, et al. Glucocorticoid treatment does not improve neurological recovery following cardiac arrest. Brain Resuscitation Clinical Trial I Study Group. JAMA, 1989; 262(24), 3427-3430.
21.	Grafton ST, Longstreth WT Jr. Steroids after cardiac arrest: a retrospective study with concurrent, nonrandomized controls. Neurology, 1988, 38(8): 1315-1316.
22.	Kuisma M, Boyd J, Voipio V, et al. Comparison of 30 and the 100% inspired oxygen concentrations during early post-resuscitation period: a randomised controlled pilot study. Resuscitation, 2006, 69(2): 199-206.
23.	Laurent I, Adrie C, Vinsonneau C, et al. High-volume hemofiltration after out-of-hospital cardiac arrest: a randomized study. J Am Coll Cardiol, 2005, 46(3): 432-437.

1. Geocadin RG, Wijdicks E, Armstrong MJ, et al. Practice guideline summary: reducing brain injury following cardiopulmonary resuscitation: report of the guideline development, dissemination, and implementation subcommittee of the American Academy of Neurology. Neurology, 2017, 88(22): 2141-2149.
2. Nielsen N, Wetterslev J, Cronberg T, et al. Targeted temperature management at 33℃ versus 36℃ after cardiac arrest. N Engl J Med, 2013, 369 (23): 2197-2206.
3. Callaway CW, Donnino MW, Fink EL, et al. Part 8: Post-cardiac arrest care: 2015 American heart association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation, 2015, 132(18 Suppl 2): S465-482.
4. Kim F, Nichol G, Maynard C, et al. Effect of prehospital induction of mild hypothermia on survival and neurological status among adults with cardiac arrest: a randomized clinical trial. JAMA, 2014, 311(1): 45-52.
5. Castrén M, Nordberg P, Svensson L, et al. Intra-arrest transnasal evaporative cooling: a randomized, prehospital, multicenter study (PRINCE: Pre-ROSC IntraNasal Cooling Effectiveness). Circulation, 2010, 122(7): 729-736.
6. Bernard SA, Smith K, Cameron P, et al. Induction of therapeutic hypothermia by paramedics after resuscitation from out-of-hospital ventricular fibrillation cardiac arrest: a randomized controlled trial. Circulation, 2010, 122(7): 737-742.
7. Bernard SA, Smith K, Cameron P, et al. Induction of prehospital therapeutic hypothermia after resuscitation from nonventricular fibrillation cardiac arrest. Crit Care Med, 2012, 40(3): 747-753.
8. Kämäräinen A, Virkkunen I, Tenhunen J, et al. Prehospital therapeutic hypothermia for comatose survivors of cardiac arrest: a randomized controlled trial. Acta Anaesthesiol Scand, 2009, 53(7): 900-907.
9. Debaty G, Maignan M, Savary D, et al. Impact of intra-arrest therapeutic hypothermia in outcomes of prehospital cardiac arrest: a randomized controlled trial. Intensive Care Med, 2014, 40(12): 1832-1842.
10. Pittl U, Schratter A, Desch S, et al. Invasive versus non-invasive cooling after in and out of hospital cardiac arrest: a randomized trial. Clin Res Cardiol, 2013, 102(8): 607-614.
11. de Waard MC, Biermann H, Brinckman SL, et al. Automated peritoneal lavage: an extremely rapid and safe way to induce hypothermia in post-resuscitation patients. Crit Care, 2013, 17(1): R31.
12. Hollenbeck RD, Wells Q, Pollock J, et al. Implementation of a standardized pathway for the treatment of cardiac arrest patients using therapeutic hypothermia: "CODE ICE". Crit Pathw Cardiol, 2012, 11(3): 91-98.
13. Damian MS, Ellenberg D, Gildemeister R, et al. Coenzyme Q10 combined with mild hypothermia after cardiac arrest: a preliminary study. Circulation, 2004, 110(19): 3011-3016.
14. Laitio R, Hynninen M, Arola O, et al. Effect of inhaled xenon on cerebral white matter damage in comatose survivors of out-of-hospital cardiac arrest: a randomized clinical trial. JAMA, 2016, 315(11): 1120-1128.
15. Roine RO, Kaste M, Kinnunen A, et al. Nimodipine after resuscitation from out-ofhospital ventricular fibrillation: a placebo-controlled, double-blind, randomized trial. JAMA, 1990, 264(24): 3171-3177.
16. Brain Resuscitation Clinical Trial II Study Group. A randomized clinical study of a calcium-entry blocker (lidoflazine) in the treatment of comatose survivors of cardiac arrest. N Engl J Med, 1991, 324(18): 1225-1231.
17. Reisinger J, Höllinger K, Lang W, et al. Does early administration of selenium improve neurological outcome after cardiac arrest? Am J Emerg Med, 2009, 27(2): 176-181.
18. Brain Resuscitation Clinical Trial I Study Group. Randomized clinical study of thiopental loading in comatose survivors of cardiac arrest. N Engl J Med, 1986, 314(7): 397-403．.
19. Longstreth WT Jr, Fahrenbruch CE, Olsufka M, et al. Randomized clinical trial of magnesium, diazepam, or both after out-of-hospital cardiac arrest. Neurology, 2002, 59(4): 506-514.
20. Jastremski M, Sutton-Tyrrell K, Vaagenes P, et al. Glucocorticoid treatment does not improve neurological recovery following cardiac arrest. Brain Resuscitation Clinical Trial I Study Group. JAMA, 1989; 262(24), 3427-3430.
21. Grafton ST, Longstreth WT Jr. Steroids after cardiac arrest: a retrospective study with concurrent, nonrandomized controls. Neurology, 1988, 38(8): 1315-1316.
22. Kuisma M, Boyd J, Voipio V, et al. Comparison of 30 and the 100% inspired oxygen concentrations during early post-resuscitation period: a randomised controlled pilot study. Resuscitation, 2006, 69(2): 199-206.
23. Laurent I, Adrie C, Vinsonneau C, et al. High-volume hemofiltration after out-of-hospital cardiac arrest: a randomized study. J Am Coll Cardiol, 2005, 46(3): 432-437.

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