Optimizing the Early Resuscitation After Out-of-Hospital Cardiac Arrest

J Intensive Care Med. 2020 Dec;35(12):1556-1563. doi: 10.1177/0885066619873318. Epub 2019 Sep 5.

Abstract

Resuscitation after out-of-hospital cardiac arrest can be one of the most challenging scenarios in acute-care medicine. The devastating effects of postcardiac arrest syndrome carry a substantial morbidity and mortality that persist long after return of spontaneous circulation. Management of these patients requires the clinician to simultaneously address multiple emergent priorities including the resuscitation of the patient and the efficient diagnosis and management of the underlying etiology. This review provides a concise evidence-based overview of the core concepts involved in the early postcardiac arrest resuscitation. It will highlight the components of an effective management strategy including addressing hemodynamic, oxygenation, and ventilation goals as well as carefully considering cardiac catheterization and targeted temperature management. An organized approach is paramount to providing effective care to patients in this vulnerable time period.

Keywords: cardiac arrest; cardiopulmonary resuscitation; critical care; return of spontaneous circulation.

Publication types

  • Review

MeSH terms

  • Cardiopulmonary Resuscitation*
  • Critical Care
  • Hemodynamics
  • Humans
  • Hypothermia, Induced*
  • Out-of-Hospital Cardiac Arrest* / therapy