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. 2011 Nov 3;1(1):45.
doi: 10.1186/2110-5820-1-45.

Postcardiac arrest syndrome: from immediate resuscitation to long-term outcome

Nicolas Mongardon  1 , Florence Dumas, Sylvie Ricome, David Grimaldi, Tarik Hissem, Frédéric Pène, Alain Cariou
Affiliations

Postcardiac arrest syndrome: from immediate resuscitation to long-term outcome

Nicolas Mongardon et al. Ann Intensive Care. .

Abstract

The prognosis for postcardiac arrest patients remains very bleak, not only because of anoxic-ischemic neurological damage, but also because of the "postcardiac arrest syndrome," a phenomenon often severe enough to cause death before any neurological evaluation. This syndrome includes all clinical and biological manifestations related to the phenomenon of global ischemia-reperfusion triggered by cardiac arrest and return of spontaneous circulation. The main component of the postcardiac arrest syndrome is an early but severe cardiocirculatory dysfunction that may lead to multiple organ failure and death.Cardiovascular support relies on conventional medical and mechanical treatment of circulatory failure. Hemodynamic stabilization is a major objective to limit secondary brain insult. When the cause of cardiac arrest is related to myocardial infarction, percutaneous coronary revascularization is associated with improved prognosis; early angiographic exploration should then be discussed when there is no obvious extracardiac cause. Therapeutic hypothermia is now the cornerstone of postanoxic cerebral protection. Its widespread use is clearly recommended, with a favorable risk-benefit ratio in selected population. Neuroprotection also is based on the prevention of secondary cerebral damages, pending the results of ongoing therapeutic evaluations regarding the potential efficiency of new therapeutic drugs.

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Figures

Figure 1
Figure 1
Schematic pathophysiology of postresuscitation damages.
Figure 2
Figure 2
Early postcardiac arrest management.
Figure 3
Figure 3
Long-term pitfalls in cardiac arrest survivors.
See this image and copyright information in PMC

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