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Emergency Neurological Life Support: Resuscitation Following Cardiac Arrest

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Abstract

Cardiac arrest is the most common cause of death in North America. Neurocritical care interventions, including targeted temperature management (TTM), have significantly improved neurological outcomes in patients successfully resuscitated from cardiac arrest. Therefore, resuscitation following cardiac arrest was chosen as an emergency neurological life support protocol. Patients remaining comatose following resuscitation from cardiac arrest should be considered for TTM. This protocol will review induction, maintenance, and re-warming phases of TTM, along with management of TTM side effects. Aggressive shivering suppression is necessary with this treatment to ensure the maintenance of a target temperature. Ancillary testing, including electrocardiography, computed tomography and/or magnetic resonance imaging of the brain, continuous electroencephalography monitoring, and correction of electrolyte, blood gas, and hematocrit changes, are also necessary to optimize outcomes.

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Authors and Affiliations

  1. Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, USA

    Jon C. Rittenberger

  2. Department of Pediatrics, Washington University School of Medicine, St. Louis, St. Louis, MO, USA

    Stuart Friess

  3. Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA

    Kees H. Polderman

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  1. Jon C. Rittenberger
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  2. Stuart Friess
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  3. Kees H. Polderman
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Correspondence to Jon C. Rittenberger.

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Rittenberger, J.C., Friess, S. & Polderman, K.H. Emergency Neurological Life Support: Resuscitation Following Cardiac Arrest. Neurocrit Care 23 (Suppl 2), 119–128 (2015). https://doi.org/10.1007/s12028-015-0171-4

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