Post-cardiac arrest care key to survival

Oct 23, 2008

The urgent need for treatment doesn't end when a person regains a pulse after suffering sudden cardiac arrest — healthcare providers need to move quickly into post-cardiac arrest care to keep a person alive and ensure the best outcome.

That's the conclusion of the American Heart Association science advisory published today in Circulation: Journal of the American Heart Association.

Brain injury, heart dysfunction, systemic inflammation and the underlying disease that caused the cardiac arrest all contribute to the high death rate of patients who initially have their pulse re-started. Collectively, these symptoms are known as post-cardiac arrest syndrome.

The largest modern report of cardiac arrest resuscitation was published by the National Registry of CPR in 2006. Among the 19,819 adults and 524 children whose hearts were re-started, in-hospital mortality rates were 67 percent and 55 percent, respectively.

The new statement says there is growing evidence that post-cardiac arrest care can lower the death rate and improve functional outcome for these patients.

"Although we have become better at restarting the heart, we are only beginning to learn and implement the best ways to keep patients alive and minimize brain damage after their heart is re-started," said Robert W. Neumar, M.D., Ph.D., head of the statement writing committee and associate professor of emergency medicine and associate director of the Center for Resuscitation Science at the University of Pennsylvania in Philadelphia.

Research shows that many aspects of post cardiac arrest syndrome can be treated. The advisory discussed treatments for various types of patients such as:

  • Unconscious adult patients resuscitated after out-of-hospital cardiac arrest were recommended to receive mild therapeutic hypothermia, which is cooling to 32°C to 34°C (89.6°F to 93.2°F) for at least 12 to 24 hours. Therapeutic hypothermia can improve survival and decrease the risk of brain damage.

  • Patients resuscitated from a cardiac arrest caused by a heart attack (as seen on an electrocardiogram, or ECG) should have immediate coronary angiography (an X-ray examination of the heart arteries) to check for artery blockages. Standard guidelines for heart attack treatment should be followed, which may include an artery-opening procedure (angioplasty) or administering a clot-busting drug to re-establish blood flow to the heart.

    The advisory also discussed treatment for high blood sugar, seizures and infection, all of which are common concerns after cardiac arrest resuscitation. Also, inserting an implantable cardioverter defibrillator (ICD) is indicated for many patients with good neurological function.

    Source: American Heart Association

    Explore further: Key element of CPR missing from guidelines

    add to favorites email to friend print save as pdf
  • Related Stories

    Hoverbike drone project for air transport takes off

    2 hours ago

    What happens when you cross a helicopter with a motorbike? The crew at Malloy Aeronautics has been focused on a viable answer and has launched a crowdfunding campaign to support its Hoverbike project, "The ...

    Study indicates large raptors in Africa used for bushmeat

    3 hours ago

    Bushmeat, the use of native animal species for food or commercial food sale, has been heavily documented to be a significant factor in the decline of many species of primates and other mammals. However, a new study indicates ...

    'Shocking' underground water loss in US drought

    3 hours ago

    A major drought across the western United States has sapped underground water resources, posing a greater threat to the water supply than previously understood, scientists said Thursday.

    Recommended for you

    Key element of CPR missing from guidelines

    16 hours ago

    Removing the head tilt/chin lift component of rescue breaths from the latest cardiopulmonary resuscitation (CPR) guidelines could be a mistake, according to Queen's University professor Anthony Ho.

    Burnout impacts transplant surgeons (w/ Video)

    Jul 28, 2014

    Despite saving thousands of lives yearly, nearly half of organ transplant surgeons report a low sense of personal accomplishment and 40% feel emotionally exhausted, according to a new national study on transplant surgeon ...

    User comments : 0