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Name of Media:

Guidelines: Post-resuscitation care

Author(s):

Jerry Nolan, Charles Deakin, Andrew Lockey, Gavin Perkins, Jasmeet Soar

Publisher or Source:

Resuscitation Council (UK) - RCUK

Type of Media:

Medical Professional Education

Media Originally for:

Critical Care Physicians,Nurses and/or Other Critical Care Medical Professionals

Country of Origin:

United Kingdom of Great Britain and Northern Ireland (the)

Primary Focus of Media:

Pre-Use of PICS Designation

COVID-19 Related:

No

Description:

Successful return of spontaneous circulation (ROSC) is the first step towards the goal of complete recovery from cardiac arrest. The complex pathophysiological processes that occur following whole body ischaemia during cardiac arrest and the subsequent reperfusion response during CPR and following successful resuscitation have been termed the post-cardiac arrest syndrome.4 Depending on the cause of the arrest, and the severity of the post-cardiac arrest syndrome, many patients will require multiple organ support and the treatment they receive during this post-resuscitation period influences significantly the overall outcome and particularly the quality of neurological recovery. The post-resuscitation phase starts at the location where ROSC is achieved but, once stabilised, the patient is transferred to the most appropriate high-care area (e.g. emergency room, cardiac catheterisation laboratory or intensive care unit (ICU) for continued diagnosis, monitoring and treatment. The post-resuscitation care algorithm (Figure 1) outlines some of the key interventions required to optimise outcome for these patients.

Of those comatose patients admitted to ICUs after cardiac arrest, as many as 40–50% survive to be discharged from hospital depending on the cause of arrest, system and quality of care. Of the patients who survive to hospital discharge, the vast majority have a good neurological outcome although many have subtle cognitive impairment.

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