{"title":"The \"SOOTEST-ICU\" bundle for optimizing cerebral hypoxia and reperfusion to minimize brain injury after resuscitation from cardiac arrest.","authors":"Rui Shao, Chenchen Hang, Xingsheng Wang, Luying Zhang, Fei Shao, Ziren Tang","doi":"10.5847/wjem.j.1920-8642.2025.050","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Post-cardiac arrest brain injury remains the leading cause of mortality and long-term disability in patients following cardiac arrest (CA). However, optimizing clinical management strategies for bundled therapy after CA still faces challenges.</p><p><strong>Methods: </strong>For this literature review, we searched PubMed, Web of Science, and SpringerLink databases for high-quality studies published between December 1982 and July 1, 2024. The search included randomized clinical trials, meta-analyses, systematic reviews, and observational studies. References in included studies were also checked to identify additional sources.</p><p><strong>Results: </strong>Many studies have identified potential targets for interventions to mitigate brain injury and improve outcomes for post-resuscitated patients. To optimize clinical management strategies to minimize brain injury after CA, we developed the acronym \"SOOTEST-ICU\" bundle, which includes \"SOOTEST\" therapy to optimize peripheral oxygen delivery and \"ICU\" intervention to optimize the cerebral oxygen cascade. The order of the \"SOOTEST\" treatment was organized based on the severity and importance of brain oxygen affecting brain injury. It includes systolic blood pressure and mean arterial pressure management, oxygenation and ventilation management, original etiological treatment, temperature control, electrolytes and acid basic status, seizure control, and targeted substrate delivery. The acronym \"ICU\" intervention includes intracerebral oxygen delivery, cerebral oxygen diffusion, and oxygen utilization.</p><p><strong>Conclusion: </strong>The \"SOOTEST-ICU\" therapy is developed to optimize oxygen and substrate cascades to minimize brain injury after CA.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"16 3","pages":"206-211"},"PeriodicalIF":2.6000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093438/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"World journal of emergency medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5847/wjem.j.1920-8642.2025.050","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Post-cardiac arrest brain injury remains the leading cause of mortality and long-term disability in patients following cardiac arrest (CA). However, optimizing clinical management strategies for bundled therapy after CA still faces challenges.
Methods: For this literature review, we searched PubMed, Web of Science, and SpringerLink databases for high-quality studies published between December 1982 and July 1, 2024. The search included randomized clinical trials, meta-analyses, systematic reviews, and observational studies. References in included studies were also checked to identify additional sources.
Results: Many studies have identified potential targets for interventions to mitigate brain injury and improve outcomes for post-resuscitated patients. To optimize clinical management strategies to minimize brain injury after CA, we developed the acronym "SOOTEST-ICU" bundle, which includes "SOOTEST" therapy to optimize peripheral oxygen delivery and "ICU" intervention to optimize the cerebral oxygen cascade. The order of the "SOOTEST" treatment was organized based on the severity and importance of brain oxygen affecting brain injury. It includes systolic blood pressure and mean arterial pressure management, oxygenation and ventilation management, original etiological treatment, temperature control, electrolytes and acid basic status, seizure control, and targeted substrate delivery. The acronym "ICU" intervention includes intracerebral oxygen delivery, cerebral oxygen diffusion, and oxygen utilization.
Conclusion: The "SOOTEST-ICU" therapy is developed to optimize oxygen and substrate cascades to minimize brain injury after CA.
背景:心脏骤停后脑损伤仍然是心脏骤停(CA)后患者死亡和长期残疾的主要原因。然而,优化CA后捆绑治疗的临床管理策略仍面临挑战。方法:在本文献综述中,我们检索了PubMed、Web of Science和SpringerLink数据库,检索了1982年12月至2024年7月1日期间发表的高质量研究。研究包括随机临床试验、荟萃分析、系统评价和观察性研究。纳入研究中的参考文献也被检查以确定其他来源。结果:许多研究已经确定了干预的潜在目标,以减轻脑损伤和改善复苏后患者的预后。为了优化临床管理策略,最大限度地减少CA后的脑损伤,我们开发了首字母缩写“SOOTEST-ICU”bundle,其中包括“SOOTEST”治疗优化外周氧输送和“ICU”干预优化脑氧级联。根据脑氧对脑损伤的影响程度和重要性,排列“SOOTEST”治疗顺序。它包括收缩压和平均动脉压管理、氧合和通气管理、原始病因治疗、温度控制、电解质和酸碱状态、癫痫发作控制和靶向底物递送。ICU干预包括脑内氧输送、脑氧扩散和氧利用。结论:“SOOTEST-ICU”治疗可优化氧和底物级联,减少CA后脑损伤。
期刊介绍:
The journal will cover technical, clinical and bioengineering studies related to multidisciplinary specialties of emergency medicine, such as cardiopulmonary resuscitation, acute injury, out-of-hospital emergency medical service, intensive care, injury and disease prevention, disaster management, healthy policy and ethics, toxicology, and sudden illness, including cardiology, internal medicine, anesthesiology, orthopedics, and trauma care, and more. The journal also features basic science, special reports, case reports, board review questions, and more. Editorials and communications to the editor explore controversial issues and encourage further discussion by physicians dealing with emergency medicine.