Cerebral Prognosis Determined During Cardiopulmonary Resuscitation

Revivability of brain functions after arrest of the systemic circulation is determined by the degree and duration of brain ischemia; in resuscitational practice, however, the extent of ischemia cannot be accurately estimated. In contrast, the time that elapses from the reestablishment of adequate brain perfusion until the reappearance of a given brain function may be precisely determined. This time to reappearance reflects the impact of brain ischemia as well as the effectiveness of basic life support and the control of postresuscitational complications. Following resuscitation brain functions are regained with different delays but in a certain interrelated chronology; this means that the determination of the reappearance time for a rapidly revived brain function may serve to predict the time of later reappearance of other functions (2). The reappearance time for a given function thus constitutes not only a precise and individual indicator of brain functional impairment but also a definite parameter of brain functional prognosis.