The Post-cardiac Arrest Syndrome

  • J. P. Nolan
  • R. W. Neumar
Conference paper

Abstract

Survival rates following in- and out-of-hospital cardiac arrest remain disappointingly low [1, 2, 3] but there is good evidence that interventions applied after return of spontaneous circulation influence significantly the chances of survival with good neurological outcome [4]. Among those patients admitted to an intensive care unit (ICU) after cardiac arrest, approximately two thirds will not survive to be discharged from hospital [5, 6], but there is considerable variation in post-cardiac arrest treatment and patient outcome between institutions [6, 7]. The prolonged period of systemic ischemia during cardiac arrest and the subsequent reperfusion response that occurs after return of spontaneous circulation results in a complex combination of pathophysiological processes that have been termed recently the post-cardiac arrest syndrome [8]. The components of post-cardiac arrest syndrome comprise post-cardiac arrest brain injury, post-cardiac arrest myocardial dysfunction, systemic ischemia/ reperfusion response, and persistent precipitating pathology. A recent scientific statement from the International Liaison Committee on Resuscitation (ILCOR) and several other organizations provides comprehensive information about the epidemiology, pathophysiology, treatment, and prognostication of the post-cardiac arrest syndrome [8]. This chapter will highlight the main messages to come from this scientific statement.

Keywords

Cardiac Arrest Mean Arterial Pressure Cerebral Perfusion Pressure Therapeutic Hypothermia Spontaneous Circulation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Copyright information

© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  • J. P. Nolan
    • 1
  • R. W. Neumar
    • 2
  1. 1.Department of Anesthesiology and Intensive CareRoyal United HospitalBathUK
  2. 2.Department of Emergency Medicine University of Pennsylvania School of MedicineHospital of the University of PennsylvaniaPhiladelphiaUSA

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