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1.3 - Principles of Management of the Patient Post-resuscitation

from Section 1 - Resuscitation and Management of the Acutely Ill Patient

Published online by Cambridge University Press:  27 July 2023

Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. The post-cardiac arrest syndrome is composed of: persistent precipitating pathology, post-cardiac arrest brain injury, post-cardiac arrest myocardial dysfunction and the systemic ischaemic/reperfusion response.

  2. 2. Hyperoxia and hypocapnia should be avoided post-return of spontaneous circulation, and oxygen saturations should be titrated to 94–98 per cent.

  3. 3. Inotropic support is commonly necessary to support adequate urine output and reducing plasma lactate levels.

  4. 4. Targeted temperature management is an important tool in improving outcomes for all cardiac arrest patients who remain unresponsive post-arrest.

  5. 5. Post-prognostication is an important opportunity for organ donation evaluation.

Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
, pp. 6 - 8
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

Intensive Care Society. Guidelines. www.ics.ac.uk/Society/Guidance/GuidanceGoogle Scholar
Nielsen, N, Wetterslev, J, Cronberg, T, et al. Targeted temperature management at 33 degrees C versus 36 degrees C after cardiac arrest. N Engl J Med 2013;369:2197–206.CrossRefGoogle Scholar
Pothiawala, FS. Post-resuscitation care. Singapore Med J 2017;58:404–7.CrossRefGoogle ScholarPubMed
Resuscitation Council UK. Advanced Life Support, 7th edn. London: Resuscitation Council UK; 2016.Google Scholar
Sandroni, C, Cariou, A, Cavallaro, F, et al. Prognostication in comatose survivors of cardiac arrest: an advisory statement from the European Resuscitation Council and the European Society of Intensive Care Medicine. Resuscitation 2014;85:1779–89.CrossRefGoogle ScholarPubMed

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