Acute Crit Care.  2019 Aug;34(3):173-178. 10.4266/acc.2019.00654.

Management of post-cardiac arrest syndrome

Affiliations
  • 1Department of Emergency Medicine, Jeju National University Hospital, Jeju, Korea. jedarm@jejunu.ac.kr

Abstract

Post-cardiac arrest syndrome is a complex and critical issue in resuscitated patients undergone cardiac arrest. Ischemic-reperfusion injury occurs in multiple organs due to the return of spontaneous circulation. Bundle of management practicies are required for post-cardiac arrest care. Early invasive coronary angiography should be considered to identify and treat coronary artery obstructive disease. Vasopressors such as norepinephrine and dobutamine are the first-line treatment for shock. Maintainance of oxyhemoglobin saturation greater than 94% but less than 100% is recommended to avoid fatality. Target temperature therapeutic hypothermia helps to resuscitated patients. Strict temperature control is required and is maintained with the help of cooling devices and monitoring the core temperature. Montorings include electrocardiogram, oxymetry, capnography, and electroencephalography (EEG) along with blood pressue, temprature, and vital signs. Seizure should be treated if EEG shows evidence of seizure or epileptiform activity. Clinical neurologic examination and magnetic resonance imaging are considered to predict neurological outcome. Glycemic control and metabolic management are favorable for a good neurological outcome. Recovery from acute kidney injury is essential for survival and a good neurological outcome.

Keyword

cardiopulmonary resuscitation; induced hypothermia; out-of-hospital cardiac arrest

MeSH Terms

Acute Kidney Injury
Capnography
Cardiopulmonary Resuscitation
Coronary Angiography
Coronary Vessels
Dobutamine
Electrocardiography
Electroencephalography
Heart Arrest
Humans
Hypothermia, Induced
Magnetic Resonance Imaging
Neurologic Examination
Norepinephrine
Out-of-Hospital Cardiac Arrest
Oxyhemoglobins
Seizures
Shock
Vital Signs
Dobutamine
Norepinephrine
Oxyhemoglobins
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