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Cardiac Arrest: Difference between revisions
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→Post-cardiac arrest treatment
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====Post-cardiac arrest treatment==== | ====Post-cardiac arrest treatment==== | ||
After cardiac arrest and return of spontaneous circulation the whole body ischemia/reperfusion affects all organ systems. Multiple organ failure, increased risk of infection, neurocognitive dysfunction and myocardial dysfunction are common problems encountered after a cardiac arrest which resembles the problems encountered with sepsis. After resuscitation strict control of oxygenation, cardiac output and glucose metabolism can improve outcome after cardiac arrest. Studies have indicated that a period of 12-24 h after cardiac arrest therapeutic hypothermia (32-34<sup>o</sup>C) can increase neurological outcome. This can be achieved by internal infusion or external cooling. Cooling should be initiated quickly after return of circulation. When cooled the temperature should be maintained without to much fluctuations. Warming of the patient should occur very slowly (0.25<sup>o</sup>C to 0.5<sup>o</sup>C per hour) to prevent rapid plasma electrolyte concentration, intravascular volume and metabolic rate changes. | After cardiac arrest and return of spontaneous circulation the whole body ischemia/reperfusion affects all organ systems. Multiple organ failure, increased risk of infection, neurocognitive dysfunction and myocardial dysfunction are common problems encountered after a cardiac arrest which resembles the problems encountered with sepsis. After resuscitation strict control of oxygenation, cardiac output and glucose metabolism can improve outcome after cardiac arrest. Treatment of the underlying cause of the cardiac resuscitation, for instance a myocardial infarction should be considered. Studies have indicated that a period of 12-24 h after cardiac arrest therapeutic hypothermia (32-34<sup>o</sup>C) can increase neurological outcome. This can be achieved by internal infusion or external cooling. Cooling should be initiated in comatose patients quickly after return of circulation. When cooled the temperature should be maintained without to much fluctuations. Warming of the patient should occur very slowly (0.25<sup>o</sup>C to 0.5<sup>o</sup>C per hour) to prevent rapid plasma electrolyte concentration, intravascular volume and metabolic rate changes. | ||
====Prognosis after cardiac arrest==== | ====Prognosis after cardiac arrest==== | ||