Acute cardiac care & resuscitation
Clinicians’ approach to predicting post-cardiac arrest outcomes for patients enrolled in a United States clinical trial
Authors' conclusion
Clinicians in our study state they follow neuroprognostication guidelines in general but often do not do so in actual practice. They reported clinical gestalt frequently informed early, highly confident prognostic judgments, and few objective tests changed initial impressions.
Study context
- Population
- Clinicians who treated a comatose post-cardiac arrest patient enrolled in the ICECAP trial
- Participants
- 30 clinicians · 19 US hospitals
- Outcome
- Frequency of reported use of objective diagnostics to formulate prognosis, compared with established guidelines
Methodological detailssemi-structured interviews, multicentre, nested in the ICECAP trial, Two authors independently analysed each interview using inductive and deductive coding
- Semi-structured interviews
- Multicentre
- Nested in the ICECAP trial
- Two authors independently analysed each interview using inductive and deductive coding
Main finding
As reported in the abstract
- Claimed adherence to local hospital neuroprognostication protocols
- 19
- Withdrawal of life-sustaining therapies (WLST) for perceived poor neurological prognosis
- 15/30
- WLST cases in which clinicians reported relying on multimodal testing
- 10/15
- Clinical gestalt used for initial prognostication
- 21/30
- High initial confidence among clinical gestalt users
- 9/21
Original publication
Clinicians’ approach to predicting post-cardiac arrest outcomes for patients enrolled in a United States clinical trial. Resuscitation. Published 27 April 2024. doi:10.
Summarised from the published abstract; every number is checked against it