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Evidence-Based Critical Care pp 13–24Cite as

Post-cardiac Arrest Management

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Abstract

This chapter will review the elements of cardiac arrest resuscitation that begin after return of spontaneous circulation (ROSC). In-hospital mortality of patients who achieve ROSC long enough to be admitted to an ICU averages 60 % with wide inter-institutional variability (40–80 %) (Carr et al. Resuscitation 80:30–34, 2009). The pathophysiology of post-cardiac arrest syndrome (PCAS) is composed of four major components: post-cardiac arrest brain injury, post-cardiac arrest myocardial dysfunction, systemic ischemia/reperfusion response, and persistent precipitating pathology (Neumar et al. Circulation 118(23):2452–2483, 2008). It is important to recognize that each component is potentially reversible and responsive to therapy. A comprehensive multidisciplinary management strategy that addresses all components of post-cardiac arrest syndrome is needed to optimize patient outcomes (Callaway et al. Circulation 132(Suppl 1):S465–S482, 2015). In addition, a reliable strategy to prognosticate neurologic outcome in persistently comatose patients is essential to prevent premature limitation of care and make possible appropriate stewardship of patient care resources (Callaway et al. Circulation 132(Suppl 1):S465–S482, 2015).

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Author information

Authors and Affiliations

  1. Emergency Medicine, University of Michigan Hospital, Ann Arbor, MI, USA

    Ronny M. Otero

  2. Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI, USA

    Robert W. Neumar

Authors
  1. Ronny M. Otero
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  2. Robert W. Neumar
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Correspondence to Ronny M. Otero .

Editor information

Editors and Affiliations

  1. Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, Michigan, USA

    Robert C. Hyzy

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© 2017 Springer International Publishing Switzerland

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Otero, R.M., Neumar, R.W. (2017). Post-cardiac Arrest Management. In: Hyzy, R. (eds) Evidence-Based Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-43341-7_2

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  • DOI: https://doi.org/10.1007/978-3-319-43341-7_2

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43339-4

  • Online ISBN: 978-3-319-43341-7

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