J Korean Med Assoc.  2023 Sep;66(9):545-553. 10.5124/jkma.2023.66.9.545.

Management of post-cardiac arrest syndrome

• Lee MJ

• KMID: 2545940
• DOI: http://doi.org/10.5124/jkma.2023.66.9.545

Abstract

Background
Despite various advances in resuscitation science, the overall survival outcome remains very low in patients who sustain sudden cardiac death. Regardless of the cause of the collapse, multiple organ systems may be injured secondary to post-cardiac arrest syndrome. This column highlights the interventions that can be incorporated as a bundle of post-resuscitation care, to narrow the gap between return of spontaneous circulation (ROSC) and neurologically intact survival.
Current Concepts
The post-cardiac arrest care algorithm presents treatment strategies and therapeutic goals to be considered in the initial stabilization stage, followed by investigating the cause of cardiac arrest and intensive care strategies to reduce additional brain damage. Immediately after ROSC, multimodal interventions required for post-ROSC care are bundled into a care regimen (treatment of the reversible cause, adequate seizure management, and glycemic control). It is also essential to establish definitive airway management to maintain normocapnic ventilation, prevent hyperoxia, and optimize hemodynamic management. Targeted temperature management after ROSC confers neuroprotection and leads to improved neurological outcomes.
Discussion and Conclusion
Post-cardiac arrest care is also emphasized as a key element in the chain of survival. The interventions outlined could lead to more patients being discharged alive from the hospital, with good neurological function. In addition, continued management planning, such as secondary prevention and social rehabilitation for cardiac arrest survivors and neurological prognostication for patients who do not recover consciousness after a certain period, are included.

Keyword

Heart arrest; Post-cardiac arrest syndrome; Return of spontaneous circulation; Targeted temperature management; 심정지; 심정지 후 증후군; 자발순환 회복; 목표체온유지요법