Management of post-cardiac arrest syndrome.
Youngjoon KangPublished in: Acute and critical care (2019)
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.
Keyphrases
- cardiac arrest
- cardiopulmonary resuscitation
- end stage renal disease
- magnetic resonance imaging
- acute kidney injury
- coronary artery
- ejection fraction
- newly diagnosed
- type diabetes
- glycemic control
- chronic kidney disease
- healthcare
- prognostic factors
- peritoneal dialysis
- cerebral ischemia
- working memory
- cardiac surgery
- patient reported outcomes
- case report
- acute myocardial infarction
- heart failure
- pulmonary hypertension
- quality improvement
- adipose tissue
- blood glucose
- oxidative stress
- skeletal muscle
- subarachnoid hemorrhage
- blood brain barrier
- insulin resistance