Critical Care of the Post-Cardiac Arrest Patient

Amy C Walker; Nicholas J Johnson

doi:10.1016/j.ccl.2018.03.009

Critical Care of the Post-Cardiac Arrest Patient

Cardiol Clin. 2018 Aug;36(3):419-428. doi: 10.1016/j.ccl.2018.03.009.

Authors

Amy C Walker¹, Nicholas J Johnson²

Affiliations

¹ Department of Emergency Medicine, University of Washington, Harborview Medical Center, 325 9th Avenue, Box 359702, Seattle, WA 98104, USA.
² Department of Emergency Medicine, University of Washington, Harborview Medical Center, 325 9th Avenue, Box 359702, Seattle, WA 98104, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Harborview Medical Center, 325 9th Avenue, Box 359702, Seattle, WA 98104, USA. Electronic address: nickj45@uw.edu.

PMID: 30293608
DOI: 10.1016/j.ccl.2018.03.009

Abstract

The post-cardiac arrest syndrome is a highly inflammatory state characterized by organ dysfunction, systemic ischemia and reperfusion injury, and persistent precipitating pathology. Early critical care should focus on identifying and treating arrest etiology and minimizing further injury to the brain and other organs by optimizing perfusion, oxygenation, ventilation, and temperature. Patients should be treated with targeted temperature management, although the exact temperature goal is not clear. No earlier than 72 hours after rewarming, prognostication using a multimodal approach should inform discussions with families regarding likely neurologic outcome.

Keywords: Cardiac arrest; Critical care; Out-of-hospital cardiac arrest; Postarrest; Post–cardiac arrest syndrome; ROSC; Return of spontaneous circulation.

Publication types

Review

MeSH terms

Cardiopulmonary Resuscitation / methods*
Critical Care / methods*
Humans
Hypothermia, Induced / methods*
Out-of-Hospital Cardiac Arrest / therapy*
Reperfusion Injury / therapy