Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-13T04:19:43.442Z Has data issue: false hasContentIssue false

Chapter 24 - Post-Arrest Neurologic Resuscitation

from Section 3 - Specific Neurological Disorders in Emergency Medicine

Published online by Cambridge University Press:  10 January 2024

Thomas P. Campbell
Affiliation:
Allegheny Health Network, Pittsburgh
Kevin M. Kelly
Affiliation:
Allegheny Health Network, Pittsburgh
Get access

Summary

The management of unresponsive post-cardiac arrest patients has been an area of much controversy and research. Interventions during the arrest, particularly no-pause cardiopulmonary resuscitation and the advent of the automated external defibrillator have placed patients in a better position to respond to post-resuscitative measures. The initiation of post-arrest therapeutic hypothermia protocols, now referred to as targeted temperature management (TTM), has resulted in significant improvement in the number of neurologically intact survivors. Post-arrest care is centered on TTM, but includes a series of protocolized steps that define the measures to be taken to optimize outcome in these patients. Post-arrest care is the fifth and final link in the American Heart Association’s out-of-hospital chain of survival.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bernard, SA, Gray, TW, Buist, MD, et al. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med 2002;346(8):557563.Google Scholar
Calabró, L, Bougouin, W, Cariou, A, et al. Effect of different methods of cooling for targeted temperature management on outcome after cardiac arrest: a systematic review and meta-analysis. Crit Care 2019;23(1):285.CrossRefGoogle ScholarPubMed
Callaway, CW, Donnino, MW, Fink, EL, et al. Part 8: Post-Cardiac Arrest Care: 2015 American Heart Association Guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2015;132:S465S482.CrossRefGoogle ScholarPubMed
Callaway, CW, Schmicker, RH, Brown, SP, et al. Early coronary angiography and induced hypothermia are associated with survival and functional recovery after out-of-hospital cardiac arrest. Resuscitation 2014;85(5):657663.CrossRefGoogle ScholarPubMed
Dragancea, I, Horn, J, Kuiper, M, et al. Neurological prognostication after cardiac arrest and targeted temperature management 33°C versus 36°C: results from a randomised controlled clinical trial. Resuscitation 2015;93:164170.CrossRefGoogle ScholarPubMed
Dumas, F, Grimaldi, D, Zuber, B, et al. Is hypothermia after cardiac arrest effective in both shockable and nonshockable patients? Insights from a large registry. Circulation 2011;123(8):877886.Google Scholar
Faro, J, Coppler, PJ, Dezfulian, C, et al. Differential association of subtypes of epileptiform activity with outcome after cardiac arrest. Resuscitation 2019;136:138145.Google Scholar
Kalra, R, Arora, G, Patel, N, et al. Targeted temperature management after cardiac arrest: systematic review and meta-analyses. Anesth Analg 2018;126(3):867875.CrossRefGoogle ScholarPubMed
Kilgannon, JH, Jones, AE, Shapiro, NI, et al. Association between arterial hyperoxia following resuscitation from cardiac arrest and in-hospital mortality. JAMA 2010;303(21):21652171.CrossRefGoogle ScholarPubMed
Knight, WA, Hart, KW, Adeoye, OM, et al. The incidence of seizures in patients undergoing therapeutic hypothermia after resuscitation from cardiac arrest. Epilepsy Res 2013;106(3):396402.CrossRefGoogle ScholarPubMed
Lucas, JM, Cocchi, MN, Salciccioli, J, et al. Neurologic recovery after therapeutic hypothermia in patients with post-cardiac arrest myoclonus. Resuscitation 2012;83(2):265269.CrossRefGoogle ScholarPubMed
Lupton, JR, Schmicker, RH, Stephens, S, et al. Outcomes with the use of bag-valve-mask ventilation during out-of-hospital cardiac arrest in the pragmatic airway resuscitation trial. Acad Emerg Med 2020;27:5.CrossRefGoogle ScholarPubMed
Lybeck, A, Friberg, H, Aneman, A, et al. Prognostic significance of clinical seizures after cardiac arrest and target temperature management. Resuscitation 2017;114:146151.CrossRefGoogle ScholarPubMed
Nichol, G, Huszti, E, Kim, F, et al. Does induction of hypothermia improve outcomes after in-hospital cardiac arrest? Resuscitation 2013;84(5):620625.CrossRefGoogle ScholarPubMed
Nielsen, N, Wetterslev, J, Cronberg, T, Erlinge, D, et al. Targeted temperature management at 33°C versus 36°C after cardiac arrest. N Engl J Med 2013;369(23):21972206.CrossRefGoogle ScholarPubMed
Perman, SM, Kirkpatrick, JN, Reitsma, AM, et al. Timing of neuroprognostication in postcardiac arrest therapeutic hypothermia. Crit Care Med 2012;40(3):719724.CrossRefGoogle ScholarPubMed
Rab, T, Kern, KB, Tamis-Holland, JE, et al. Cardiac arrest: a treatment algorithm for emergent invasive cardiac procedures in the resuscitated comatose patient. J Am Coll Cardiol 2015;66(1):6273.Google Scholar
Rittenberger, JC, Weissman, A, Baldwin, M, et al. Preliminary experience with point-of-care EEG in post-cardiac arrest patients. Resuscitation 2019;135:98102.CrossRefGoogle ScholarPubMed
Roberts, BW, Kilgannon, JH, Chansky, ME, et al. Association between postresuscitation partial pressure of arterial carbon dioxide and neurological outcome in patients with post-cardiac arrest syndrome. Circulation 2013;127(21):21072113.Google Scholar
Seder, DB, Sunde, K, Rubertsson, S, et al. Neurologic outcomes and postresuscitation care of patients with myoclonus following cardiac arrest. Crit Care Med 2015;43(5):965972.CrossRefGoogle ScholarPubMed
Soar, J, Berg, KM, Andersen, LW, et al. Adult Advanced Life Support: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Resuscitation 2020;156:A80A119.CrossRefGoogle ScholarPubMed
Stanger, D, Kawano, T, Malhi, N, et al. Door-to-Targeted temperature management initiation time and outcomes in out-of-hospital cardiac arrest: insights from the Continuous Chest Compressions Trial. J Am Heart Assoc 2019;8(9):e012001.CrossRefGoogle ScholarPubMed
Szarpak, L, Filipiak, KJ, Mosteller, L, et al. Survival, neurological and safety outcomes after out of hospital cardiac arrests treated by using prehospital therapeutic hypothermia: a systematic review and meta-analysis. Am J Emerg Med 2020;20:S0735-6757.Google Scholar
Testori, C, Sterz, F, Behringer, W, et al. Mild therapeutic hypothermia is associated with favourable outcome in patients after cardiac arrest with non-shockable rhythms. Resuscitation 2011;82(9):11621167.CrossRefGoogle ScholarPubMed
Yang, MC, Meng-Jun, W, Xiao-Yan, X, et al. Coronary angiography or not after cardiac arrest without ST segment elevation: a systematic review and meta-analysis. Medicine (Baltimore) 2020;99(41):e22197.CrossRefGoogle ScholarPubMed
Yoshida, M, Yoshida, T, Masui, Y, et al. Association between therapeutic hypothermia and outcomes in patients with non-shockable out-of-hospital cardiac arrest developed after emergency medical service arrival (SOS-KANTO 2012 Analysis Report). Neurocrit Care 2019;30(2):429439.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×