The Post-cardiac Arrest Syndrome

  • J. P. Nolan
  • R. W. Neumar


Survival rates following in- and out-of-hospital cardiac arrest remain disappointingly low [1, 2, 3] but there is good evidence that interventions applied after return of spontaneous circulation influence significantly the chances of survival with good neurological outcome [4]. Among those patients admitted to an intensive care unit (ICU) after cardiac arrest, approximately two thirds will not survive to be discharged from hospital [5, 6], but there is considerable variation in post-cardiac arrest treatment and patient outcome between institutions [6, 7]. The prolonged period of systemic ischemia during cardiac arrest and the subsequent reperfusion response that occurs after return of spontaneous circulation results in a complex combination of pathophysiological processes that have been termed recently the post-cardiac arrest syndrome [8]. The components of post-cardiac arrest syndrome comprise post-cardiac arrest brain injury, post-cardiac arrest myocardial dysfunction, systemic ischemia/ reperfusion response, and persistent precipitating pathology. A recent scientific statement from the International Liaison Committee on Resuscitation (ILCOR) and several other organizations provides comprehensive information about the epidemiology, pathophysiology, treatment, and prognostication of the post-cardiac arrest syndrome [8]. This chapter will highlight the main messages to come from this scientific statement.


Cardiac Arrest Mean Arterial Pressure Cerebral Perfusion Pressure Therapeutic Hypothermia Spontaneous Circulation 
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Copyright information

© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  • J. P. Nolan
    • 1
  • R. W. Neumar
    • 2
  1. 1.Department of Anesthesiology and Intensive CareRoyal United HospitalBathUK
  2. 2.Department of Emergency Medicine University of Pennsylvania School of MedicineHospital of the University of PennsylvaniaPhiladelphiaUSA

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