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Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,036

Periodicità: Mensile

ISSN 0375-9393

Online ISSN 1827-1596


Minerva Anestesiologica 2010 Maggio;76(5):362-8


Post-cardiac arrest syndrome

Binks A. 1, Nolan J. P. 2

1 Department of Anaesthesia and Intensive Care, Bristol Royal Infirmary, Bristol, UK;
2 Department of Anaesthesia and Intensive Care, Royal United Hospital, Bath, UK

Following successful resuscitation from cardiac arrest, neurological impairment as well as other types of organ dysfunction still cause significant morbidity and mortality. The whole-body ischemia-reperfusion response that occurs during cardiac arrest and subsequent restoration of systemic circulation results in a series of pathophysiological processes that have been termed the post-cardiac arrest syndrome. The components of the post-cardiac arrest syndrome comprise post-cardiac arrest brain injury, post-cardiac arrest myocardial dysfunction, the systemic ischemia-reperfusion response and persistent precipitating pathology. Management of the post-cardiac arrest syndrome involves intensive care support with input from various other medical specialties in a coordinated fashion. Management of ventilation aims for normal carbon dioxide values and normoxia rather than hyperoxia. Management of the circulation commonly requires vasoactive support to overcome (often transient) myocardial dysfunction. Particular attention should be given to evidence of cardiac ischemia and referral for urgent angiography and percutaneous coronary intervention, if appropriate, should be available to all. Optimizing neurological recovery will involve seizure control, management of hyperglycemia and therapeutic hypothermia. Prognostication following cardiac arrest remains difficult, but there are diagnostic tests that may be used with some degree of accuracy.

lingua: Inglese


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