Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Apr 20;12(8):3009.
doi: 10.3390/jcm12083009.

Developments in Post-Resuscitation Care for Out-of-Hospital Cardiac Arrests in Adults-A Narrative Review

Stephan Katzenschlager  1 , Erik Popp  1 , Jan Wnent  2   3   4 , Markus A Weigand  1 , Jan-Thorsten Gräsner  2   3
Affiliations
Review

Developments in Post-Resuscitation Care for Out-of-Hospital Cardiac Arrests in Adults-A Narrative Review

Stephan Katzenschlager et al. J Clin Med. .

Abstract

This review focuses on current developments in post-resuscitation care for adults with an out-of-hospital cardiac arrest (OHCA). As the incidence of OHCA is high and with a low percentage of survival, it remains a challenge to treat those who survive the initial phase and regain spontaneous circulation. Early titration of oxygen in the out-of-hospital phase is not associated with increased survival and should be avoided. Once the patient is admitted, the oxygen fraction can be reduced. To maintain an adequate blood pressure and urine output, noradrenaline is the preferred agent over adrenaline. A higher blood pressure target is not associated with higher rates of good neurological survival. Early neuro-prognostication remains a challenge, and prognostication bundles should be used. Established bundles could be extended by novel biomarkers and methods in the upcoming years. Whole blood transcriptome analysis has shown to reliably predict neurological survival in two feasibility studies. This needs further investigation in larger cohorts.

Keywords: intensive care; out-of-hospital cardiac arrest; post-resuscitation care; resuscitation.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

References

    1. Gräsner J.-T., Herlitz J., Tjelmeland I.B., Wnent J., Masterson S., Lilja G., Bein B., Böttiger B.W., Rosell-Ortiz F., Nolan J.P., et al. European Resuscitation Council Guidelines 2021: Epidemiology of cardiac arrest in Europe. Resuscitation. 2021;161:61–79. doi: 10.1016/j.resuscitation.2021.02.007. - DOI - PubMed
    1. Gräsner J.-T., Wnent J., Herlitz J., Perkins G.D., Lefering R., Tjelmeland I., Koster R.W., Masterson S., Rossell-Ortiz F., Maurer H., et al. Survival after out-of-hospital cardiac arrest in Europe—Results of the EuReCa TWO study. Resuscitation. 2020;148:218–226. doi: 10.1016/j.resuscitation.2019.12.042. - DOI - PubMed
    1. Benjamin E.J., Virani S.S., Callaway C.W., Chamberlain A.M., Chang A.R., Cheng S., Chiuve S.E., Cushman M., Delling F.N., Deo R., et al. Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association. Circulation. 2018;137:e67–e492. doi: 10.1161/CIR.0000000000000558. - DOI - PubMed
    1. Ong M.E.H., Shin S.D., De Souza N.N.A., Tanaka H., Nishiuchi T., Song K.J., Ko P.C.-I., Leong B.S.-H., Khunkhlai N., Naroo G.Y., et al. Outcomes for out-of-hospital cardiac arrests across 7 countries in Asia: The Pan Asian Resuscitation Outcomes Study (PAROS) Resuscitation. 2015;96:100–108. doi: 10.1016/j.resuscitation.2015.07.026. - DOI - PubMed
    1. Andrew E., Nehme Z., Lijovic M., Bernard S., Smith K. Outcomes following out-of-hospital cardiac arrest with an initial cardiac rhythm of asystole or pulseless electrical activity in Victoria, Australia. Resuscitation. 2014;85:1633–1639. doi: 10.1016/j.resuscitation.2014.07.015. - DOI - PubMed

LinkOut - more resources