Neuroprotective Treatment of Postanoxic Encephalopathy: Review of the Literature and Ongoing Trials.

Authors

Jong Woo Lee, Jeannette Hofmeijer

Published in

Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society. Apr 03, 2026. Epub Apr 03, 2026.

Abstract

Postanoxic encephalopathy is a common consequence of cardiac arrest, characterized by varying degrees of global cerebral hypoxic-ischemic injury. Despite advances in resuscitation science and critical care, neurologic outcome is essentially unchanged over the past decades. Although various treatment approaches to mitigate brain injury have been proposed, none of these has been unequivocally associated with improved neurologic outcome. This review provides an overview of the evidence from previous studies and ongoing clinical trials. Based on successes and limitations in recent research, we recommend EEG-based patient stratification and sufficiently powered subgroups for future trials. We also recommend outcome measures that provide more granularity than the current ordinal outcome scales, such as screening instruments for cognitive and emotional functioning. Adaptive randomized trial designs using a single master protocol and Bayesian statistics can provide an efficient platform for testing multiple treatments against a common control group, simultaneously. Treatments based on active stimulation of neuro- and synaptogenesis instead of prevention of secondary injury are promising.

PMID:
42359658
Bibliographic data and abstract were imported from PubMed on 26 Jun 2026.

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