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Chapter 22 - Post-resuscitation care

from Section II: - Systemic disorders and management

Published online by Cambridge University Press:  06 July 2010

Edited by
Edited in association with
Fang Gao Smith
Affiliation:
University of Warwick
Joyce Yeung
Affiliation:
West Midlands Deanery
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Summary

Current theories on the concept of a post-resuscitation syndrome describe the development of a systemic inflammatory response/sepsis following resuscitation from cardiac arrest. Critical care treatments during the post-resuscitation phase should focus on correcting hypoxia and hypercarbia, optimizing organ perfusion, identifying and treating the underlying cause of the cardiac arrest and optimizing neurological outcomes. Several randomized controlled trials and a meta-analysis have shown that therapeutic hypothermia is associated with improved survival and neurological outcome in initially comatose survivors of cardiac arrest. Observational studies in cardiac arrest survivors have shown that hyperglycaemia after return of spontaneous circulation is associated with an adverse outcome. Myocardial dysfunction is common after cardiac arrest and usually starts to improve within 72 hours after return of spontaneous circulation. Acidosis and control of seizures are explained in this chapter. The ability to predict the likely neurological outcome of a patient following admission to critical care is important.
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Publisher: Cambridge University Press
Print publication year: 2010

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