Post-Cardiac Arrest: Mechanisms, Management, and Future Perspectives

doi:10.3390/jcm12010259

Review

. 2022 Dec 29;12(1):259.

doi: 10.3390/jcm12010259.

Post-Cardiac Arrest: Mechanisms, Management, and Future Perspectives

Taline Lazzarin¹, Carolina Rodrigues Tonon¹, Danilo Martins¹, Edson Luiz Fávero Jr¹, Thiago Dias Baumgratz¹, Filipe Welson Leal Pereira¹, Victor Rocha Pinheiro¹, Raquel Simões Ballarin¹, Diego Aparecido Rios Queiroz¹, Paula Schmidt Azevedo¹, Bertha Furlan Polegato¹, Marina Politi Okoshi¹, Leonardo Zornoff¹, Sergio Alberto Rupp de Paiva¹, Marcos Ferreira Minicucci¹

Affiliations

PMID: 36615059
PMCID: PMC9820907
DOI: 10.3390/jcm12010259

Review

Post-Cardiac Arrest: Mechanisms, Management, and Future Perspectives

Taline Lazzarin et al. J Clin Med. 2022.

. 2022 Dec 29;12(1):259.

doi: 10.3390/jcm12010259.

Authors

Affiliation

¹ Internal Medicine Department, Botucatu Medical School, Universidade Estadual Paulista (UNESP), Botucatu 18607-741, Brazil.

PMID: 36615059
PMCID: PMC9820907
DOI: 10.3390/jcm12010259

Abstract

Cardiac arrest is an important public health issue, with a survival rate of approximately 15 to 22%. A great proportion of these deaths occur after resuscitation due to post-cardiac arrest syndrome, which is characterized by the ischemia-reperfusion injury that affects the role body. Understanding physiopathology is mandatory to discover new treatment strategies and obtain better results. Besides improvements in cardiopulmonary resuscitation maneuvers, the great increase in survival rates observed in recent decades is due to new approaches to post-cardiac arrest care. In this review, we will discuss physiopathology, etiologies, and post-resuscitation care, emphasizing targeted temperature management, early coronary angiography, and rehabilitation.

Keywords: cardiac arrest; physiopathology; rehabilitation; targeted temperature management.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
Post-cardiac arrest management.

**Figure 2**
Neuroprognostication algorithm. Abbreviations: EEG—electroencephalogram, SSEP—somatosensory evoked potentials, NSE—neuron-specific enolase, CT—computerized tomography, MRI—Magnetic resonance Imaging. Legends: (1) suppressed background with or without periodic discharges and burst-suppression; (2) Bilateral absence of somatosensory evoked cortical N20-potentials.

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References

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1. Chan P.S., McNally B., Tang F., Kellermann A. Recent Trends in Survival from Out-of-Hospital Cardiac Arrest in the United States. Circulation. 2014;130:1876–1882. doi: 10.1161/CIRCULATIONAHA.114.009711. - DOI - PMC - PubMed
1. Girotra S., Nallamothu B.K., Spertus J.A., Li Y., Krumholz H.M., Chan P.S. Trends in Survival after In-Hospital Cardiac Arrest. N. Engl. J. Med. 2012;367:1912–1920. doi: 10.1056/NEJMoa1109148. - DOI - PMC - PubMed
1. Nolan J.P., Neumar R.W., Adrie C., Aibiki M., Berg R.A., Böttiger B.W., Callaway C., Clark R.S., Geocadin R.G., Jauch E.C., et al. Post-cardiac arrest syndrome: Epidemiology, pathophysiology, treatment, and prognostication: A Scientific Statement from the International Liaison Committee on Resuscitation; the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; the Council on Stroke. Resuscitation. 2008;79:350–379. doi: 10.1016/j.resuscitation.2008.09.017. - DOI - PubMed
1. Eltzschig H.K., Eckle T. Ischemia and reperfusion—From mechanism to translation. Nat. Med. 2011;17:1391–1401. doi: 10.1038/nm.2507. - DOI - PMC - PubMed

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[1] Nolan J.P., Soar J., Zideman D.A., Biarent D., Bossaert L.L., Deakin C., Koster R.W., Wyllie J., Böttiger B. European Resuscitation Council Guidelines for Resuscitation 2010 Section 1. Executive summary. Resuscitation. 2010;81:1219–1276. doi: 10.1016/j.resuscitation.2010.08.021. - DOI - PubMed

[2] Nolan J.P., Soar J., Zideman D.A., Biarent D., Bossaert L.L., Deakin C., Koster R.W., Wyllie J., Böttiger B. European Resuscitation Council Guidelines for Resuscitation 2010 Section 1. Executive summary. Resuscitation. 2010;81:1219–1276. doi: 10.1016/j.resuscitation.2010.08.021. - DOI - PubMed

[3] Chan P.S., McNally B., Tang F., Kellermann A. Recent Trends in Survival from Out-of-Hospital Cardiac Arrest in the United States. Circulation. 2014;130:1876–1882. doi: 10.1161/CIRCULATIONAHA.114.009711. - DOI - PMC - PubMed

[4] Chan P.S., McNally B., Tang F., Kellermann A. Recent Trends in Survival from Out-of-Hospital Cardiac Arrest in the United States. Circulation. 2014;130:1876–1882. doi: 10.1161/CIRCULATIONAHA.114.009711. - DOI - PMC - PubMed

[5] Girotra S., Nallamothu B.K., Spertus J.A., Li Y., Krumholz H.M., Chan P.S. Trends in Survival after In-Hospital Cardiac Arrest. N. Engl. J. Med. 2012;367:1912–1920. doi: 10.1056/NEJMoa1109148. - DOI - PMC - PubMed

[6] Girotra S., Nallamothu B.K., Spertus J.A., Li Y., Krumholz H.M., Chan P.S. Trends in Survival after In-Hospital Cardiac Arrest. N. Engl. J. Med. 2012;367:1912–1920. doi: 10.1056/NEJMoa1109148. - DOI - PMC - PubMed

[7] Nolan J.P., Neumar R.W., Adrie C., Aibiki M., Berg R.A., Böttiger B.W., Callaway C., Clark R.S., Geocadin R.G., Jauch E.C., et al. Post-cardiac arrest syndrome: Epidemiology, pathophysiology, treatment, and prognostication: A Scientific Statement from the International Liaison Committee on Resuscitation; the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; the Council on Stroke. Resuscitation. 2008;79:350–379. doi: 10.1016/j.resuscitation.2008.09.017. - DOI - PubMed

[8] Nolan J.P., Neumar R.W., Adrie C., Aibiki M., Berg R.A., Böttiger B.W., Callaway C., Clark R.S., Geocadin R.G., Jauch E.C., et al. Post-cardiac arrest syndrome: Epidemiology, pathophysiology, treatment, and prognostication: A Scientific Statement from the International Liaison Committee on Resuscitation; the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; the Council on Stroke. Resuscitation. 2008;79:350–379. doi: 10.1016/j.resuscitation.2008.09.017. - DOI - PubMed

[9] Eltzschig H.K., Eckle T. Ischemia and reperfusion—From mechanism to translation. Nat. Med. 2011;17:1391–1401. doi: 10.1038/nm.2507. - DOI - PMC - PubMed

[10] Eltzschig H.K., Eckle T. Ischemia and reperfusion—From mechanism to translation. Nat. Med. 2011;17:1391–1401. doi: 10.1038/nm.2507. - DOI - PMC - PubMed

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Post-Cardiac Arrest: Mechanisms, Management, and Future Perspectives

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Post-Cardiac Arrest: Mechanisms, Management, and Future Perspectives

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