Cardiac Arrest: Difference between revisions

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 therapeutic hypothermia (32-34^oC) during 12-24h after cardiac arrest can increase neurological outcome. This can be achieved by internal infusion or external cooling. Therapeutic hypothermia 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^oC to 0.5^oC per hour) to prevent rapid plasma electrolyte concentration changes, intravascular volume and metabolic rate changes.