The evolving paradigm of individualized postresuscitation care after cardiac arrest.

Document Type

Article

Publication Date

11-2016

Institution/Department

Critical Care Medicine; Neurology and Neuroscience; Nursing

Journal Title

American Journal of Critical Care

MeSH Headings

Resuscitation, Cardiopulmonary; Heart Arrest Therapy; Critical Care Nursing; Reperfusion Injury; Hypothermia, Induced; Male; Aged; Adult; Female; Middle Age; Hypothermia, Induced Adverse Effects; Seizures Prevention and Control; Drugs Pharmacokinetics; Aged: 65+ years; Adult: 19-44 years; Middle Aged: 45-64 years; Male; Female

Abstract

The postresuscitation period after a cardiac arrest is characterized by a wide range of physiological derangements. Variations between patients include preexisting medical problems, the underlying cause of the cardiac arrest, presence or absence of hemodynamic and circulatory instability, severity of the ischemia-reperfusion injury, and resuscitation-related injuries such as pulmonary aspiration and rib or sternal fractures. Although protocols can be applied to many elements of postresuscitation care, the widely disparate clinical condition of cardiac arrest survivors requires an individualized approach that stratifies patients according to their clinical profile and targets specific treatments to patients most likely to benefit. This article describes such an individualized approach, provides a practical framework for evaluation and triage at the bedside, and reviews concerns specific to all members of the interprofessional postresuscitation care team.

First Page

556

Last Page

565

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