Abstract
Since the introduction of modern cardiopulmonary resuscitation (CPR) and emergency cardiovascular care 50 years ago, considerable progress has been achieved in the management of cardiac arrest patients (1). Nevertheless, patients admitted to the intensive care unit (ICU) after successful resuscitation are at high risk for postresuscitation disease (2), a condition of multiple life-threatening disorders, including neurologic failure. Despite advances in cardiac arrest resuscitation, neurologic impairments and other organ dysfunctions cause considerable mortality and morbidity after restoration of spontaneous cardiac activity. Community-wide studies found mortality rates ranging from 4% to 33% depending on the chain of survival. Reports of higher survival rates in patients treated with mild hypothermia (3, 4) after successful cardiac arrest resuscitation confirm that the outcome is determined not only by the time to circulation recovery, but also by pathogenic processes that are triggered by the cardiac arrest but continue to evolve subsequently, causing damage to the nervous system and other organs.
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References
Eisenberg MS, Mengert TJ. Cardiac resuscitation. N Engl J Med 2001;344:1304–13.
Negovsky VA. The second step in resuscitation—the treatment of the “post-resuscitation disease”. Resuscitation 1972;1:1–7.
Bernard SA, et al. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med 2002;346:557–63.
The Hypothermia after Cardiac Arrest Study Group. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 2002;346:549–56.
Adrie C, et al. Successful cardiopulmonary resuscitation after cardiac arrest as a “sepsis-like” syndrome. Circulation 2002;106:562–8.
Gorcsan J 3rd, et al. Rapid estimation of left ventricular contractility from end-systolic relations by echocardiographic automated border detection and femoral arterial pressure. Anesthesiology 1994;81:553–62; discussion 27A.
Adrie C, et al. Coagulopathy after successful cardiopulmonary resuscitation following cardiac arrest: implication of the protein C anticoagulant pathway. J Am Coll Cardiol 2005;46:21–8.
Hekimian G, et al. Cortisol levels and adrenal reserve after successful cardiac arrest resuscitation. Shock 2004;22:116–9.
Laurent I, et al. Reversible myocardial dysfunction in survivors of out-of-hospital cardiac arrest. J Am Coll Cardiol 2002;40:2110–6.
Spaulding CM, et al. Immediate coronary angiography in survivors of out-of-hospital cardiac arrest. N Engl J Med 1997;336:1629–33.
Richard C, et al. Early use of the pulmonary artery catheter and outcomes in patients with shock and acute respiratory distress syndrome: a randomized controlled trial. JAMA 2003;290:2713–20.
Dorian P, et al. Amiodarone as compared with lidocaine for shock-resistant ventricular fibrillation. N Engl J Med 2002;346:884–90.
Kudenchuk PJ, et al. Amiodarone for resuscitation after out-of-hospital cardiac arrest due to ventricular fibrillation. N Engl J Med 1999;341:871–8.
Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Part 6: advanced cardiovascular life support: section 8: postresuscitation care. The American Heart Association in collaboration with the International Liaison Committee on Resuscitation. Circulation 2000;102:I166–71.
Callans DJ. Management of the patient who has been resuscitated from sudden cardiac death. Circulation 2002;105:2704–7.
Levine JH, et al. Intravenous amiodarone for recurrent sustained hypotensive ventricular tachyarrhythmias. Intravenous Amiodarone Multicenter Trial Group. J Am Coll Cardiol 1996;27:67–75.
Killingsworth CR, et al. Short-acting beta-adrenergic antagonist esmolol given at reperfusion improves survival after prolonged ventricular fibrillation. Circulation 2004;109:2469–74.
Böttiger BW, Martin E. Thrombolytic therapy during cardiopulmonary resuscitation and the role of coagulation activation after cardiac arrest. Curr Opin Crit Care 2001;7:176–83.
Fischer M, et al. Thrombolysis using plasminogen activator and heparin reduces cerebral no-reflow after resuscitation from cardiac arrest: an experimental study in the cat. Intensive Care Med 1996;22:1214–23.
Laurent I, et al. High-volume hemofiltration after out-of-hospital cardiac arrest: a randomized study. J Am Coll Cardiol 2005;46:432–7.
Guidelines for cardiopulmonary resuscitation and emergency cardiac care. Emergency Cardiac Care Committee and Subcommittees, American Heart Association. Part VIII. Ethical considerations in resuscitation. JAMA 1992;268:2282–8.
Zandbergen EG, et al. Systematic review of early prediction of poor outcome in anoxic-ischaemic coma. Lancet 1998;352:1808–12.
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Adrie, C., Laurent, I., Monchi, M. (2008). Post-Cardiopulmonary Resuscitation Management in the Intensive Care Unit. In: Mebazaa, A., Gheorghiade, M., Zannad, F.M., Parrillo, J.E. (eds) Acute Heart Failure. Springer, London. https://doi.org/10.1007/978-1-84628-782-4_77
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DOI: https://doi.org/10.1007/978-1-84628-782-4_77
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