Document Detail


Postresuscitation care: entering a new era.
MedLine Citation:
PMID:  20216308     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: The purpose of this study is to discuss recent data relating to the treatment of cardiac arrest survivors. This is a rapidly evolving component of resuscitation medicine that impacts significantly on the quality of survival after cardiac arrest. RECENT FINDINGS: The postcardiac arrest syndrome comprises postcardiac arrest brain injury, postcardiac arrest myocardial dysfunction, the systemic ischaemia/reperfusion response, and the persistent precipitating disease. Primary percutaneous coronary intervention is the preferred method for restoring coronary perfusion when cardiac arrest has been caused by an ST-elevation myocardial infarction. Many cardiac arrest survivors with non-ST-elevation myocardial infarction may also benefit from urgent percutaneous coronary intervention. Comatose cardiac arrest survivors should be managed with a moderate blood glucose target range of below 10 mmol/l (180 mg/dl). Therapeutic hypothermia is now generally accepted as part of a treatment strategy for comatose survivors of cardiac arrest, but its use may render conventional methods of prognostication unreliable. SUMMARY: Survivors from cardiac arrest develop a postcardiac arrest syndrome. Postresuscitation care, including primary percutaneous coronary intervention, therapeutic hypothermia, and control of blood sugar, improves survival and neurological outcome in cardiac arrest survivors. Completely reliable prognostication in comatose survivors of cardiac arrest is difficult to achieve.
Authors:
Jerry P Nolan; Jasmeet Soar
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in critical care     Volume:  16     ISSN:  1531-7072     ISO Abbreviation:  Curr Opin Crit Care     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-13     Completed Date:  2010-08-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9504454     Medline TA:  Curr Opin Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  216-22     Citation Subset:  IM    
Affiliation:
Royal United Hospital, Bath, UK. jerry.nolan@ruh.nhs.uk <jerry.nolan@ruh.nhs.uk>
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Balloon
Blood Glucose / analysis
Cardiopulmonary Resuscitation / methods*,  mortality
Cerebrovascular Disorders / etiology,  mortality
Heart Arrest / complications*,  mortality,  therapy*
Heart Diseases / etiology,  mortality
Humans
Hypothermia, Induced
Prognosis
Reperfusion Injury / etiology,  mortality
Chemical
Reg. No./Substance:
0/Blood Glucose

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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