Cerebral Edema After Cardiopulmonary Resuscitation: A Therapeutic Target Following Cardiac Arrest?

Neurocrit Care. 2018 Jun;28(3):276-287. doi: 10.1007/s12028-017-0474-8.

Abstract

We sought to review the role that cerebral edema plays in neurologic outcome following cardiac arrest, to understand whether cerebral edema might be an appropriate therapeutic target for neuroprotection in patients who survive cardiopulmonary resuscitation. Articles indexed in PubMed and written in English. Following cardiac arrest, cerebral edema is a cardinal feature of brain injury and is a powerful prognosticator of neurologic outcome. Like other conditions characterized by cerebral ischemia/reperfusion, neuroprotection after cardiac arrest has proven to be difficult to achieve. Neuroprotection after cardiac arrest generally has focused on protecting neurons, not the microvascular endothelium or blood-brain barrier. Limited preclinical data suggest that strategies to reduce cerebral edema may improve neurologic outcome. Ongoing research will be necessary to determine whether targeting cerebral edema will improve patient outcomes after cardiac arrest.

Keywords: Blood–brain barrier; Cardiac arrest; Cerebral edema; Ischemia/reperfusion injury; Neuroprotection.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Brain Edema / etiology
  • Brain Edema / therapy*
  • Cardiopulmonary Resuscitation / adverse effects*
  • Heart Arrest / complications
  • Heart Arrest / therapy*
  • Humans
  • Reperfusion Injury / complications*