This Article Full Text Full Text (PDF) All Versions of this Article: 112/24_suppl/IV-84    most recent CIRCULATIONAHA.105.166560v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Search for Related Content Related Collections AHA Statements and Guidelines

(Circulation. 2005;112:IV-84 – IV-88.)
© 2005 American Heart Association, Inc.

2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

Part 7.5: Postresuscitation Support

	Introduction

 
Few randomized controlled clinical trials deal specifically with supportive care following cardio-pulmonary-cerebral resuscitation (CPCR) from cardiac arrest. Nevertheless, postresuscitation care has significant potential to improve early mortality caused by hemodynamic instability and multi-organ failure and later mortality/morbidity resulting from brain injury.¹ This section summarizes our evolving understanding of the hemodynamic, neurologic, and metabolic abnormalities encountered in patients who are resuscitated from cardiac arrest.

Initial objectives of postresuscitation care are to

• Optimize cardiopulmonary function and systemic perfusion, especially perfusion to the brain
  
• Transport the victim of out-of-hospital cardiac arrest to the hospital emergency department (ED) and continue care in an appropriately equipped critical care unit
  
• Try to identify the precipitating causes of the arrest
  
• Institute measures to prevent recurrence
  
• Institute measures that may improve long-term, neurologically intact survival
  

	Improving Postresuscitation Outcomes

 
Postresuscitation care is a critical component of advanced life support. Patient mortality remains high after return of spontaneous circulation (ROSC) and initial stabilization. Ultimate prognosis in the first 72 hours may be difficult to determine,² yet survivors of cardiac arrest have the potential to lead normal lives.^3–5 During postresuscitation care providers should (1) optimize hemodynamic, respiratory, and neurologic support; (2) identify and treat reversible causes of arrest; and (3) monitor temperature and consider treatment for disturbances of temperature regulation and metabolism. The first sections below discuss initial stabilization and temperature/metabolic factors that may be relevant to improving postresuscitation outcome, particularly in the critically ill survivor. Subsequent sections highlight organ-specific evaluation and support.

	Return of Spontaneous Circulation

 
The principal objective of postresuscitation care is the re-establishment of effective . . . [Full Text of this Article]

This article has been cited by other articles:

				A K. McQuillan Inducing Hypothermia After Cardiac Arrest Crit. Care Nurse, August 1, 2009; 29(4): 75 - 78. [Full Text] [PDF]