Use of a Standardized Treatment Protocol for Post-cardiac Resuscitation Care
For a long time, the outcome of patients after out-of-hospital cardiac arrest has been extremely poor, with only 5–10 % of survivors having a good neurological outcome. In recent years, several studies have demonstrated an increase in survival of cardiac arrest patients admitted to the intensive care unit (ICU), often with more than 60 % having good neurological outcome [1, 2, 3, 4, 5, 6]. Since the introduction of cardiopulmonary resuscitation (CPR) in the early 1960s by Safar and McMahon (mouth-to-mouth respiration)  and Kouwenhoven et al. (closed chest-compression) , the emphasis in resuscitation medicine has been on the treatment of cardiac arrest until return of spontaneous circulation, with manual CPR and early defibrillation of convertible cardiac rhythms being the two most important items. The general consensus was that improvement of outcome of cardiac arrest patients would solely lie in shortening the period of circulatory standstill, thus minimizing the, mainly neurological, damage. Having restored the circulation, treating physicians “could only wait and see what the outcome would be”. However, alongside the processes of recovery and compensation, a pathological state may develop with associated organ failure — the so-called post-resuscitation syndrome. Physicians should be aware of this condition and actively treat its complications to improve the condition of the patient and to increase the chance of a good neurological outcome after cardiac arrest. Induced mild hypothermia is an important factor in this aspect and has become an established treatment for the post-resuscitation patient. However, induced mild hypothermia is not the sole treatment modality that should be used.
KeywordsCardiac Arrest Mean Arterial Blood Pressure Therapeutic Hypothermia Mild Hypothermia Advanced Life Support
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