Clinical practice. Neurologic prognosis after cardiac arrest.

A 55-year-old man collapses while jogging through the park. A bystander finds him unconscious and without a pulse and initiates cardiopulmonary resuscitation while an ambulance is summoned. On arrival in the emergency room, the patient is in ventricular fibrillation. Spontaneous circulation is reestablished, but he remains comatose with absent pupillary reflexes. He remains unconscious after treatment with hypothermia for 24 hours. What would you advise regarding his neurologic prognosis?

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