View source for Post cardiac arrest care

==Management==
*Maintain perfusion (cerebral)
**Treat [[hypotension]]
**Ignore [[hypertension]]
**Maintain normal PaCO2 (~40)
*Target [[oxygen|normoxia]]
**PaO2 80-120
*[[Therapeutic Hypothermia]]
*PCI
**Early reperfusion therapy is important to ID coronaries as ECG cannot reliably predict them in these cases<ref>Kern, KB. Optimal Treatment of Patients Surviving Out-of-Hospital Cardiac Arrest. J Am Coll Cardiol Intv. 2012; 5(6):597-605. doi:10.1016/j.jcin.2012.01.017</ref>
**More recent data suggests that there is no difference in 90 day mortality/neurologic outcomes for immediate vs. delayed angiography in patients who had a shockable rhythm during arrest <ref>“Coronary Angiography after Cardiac Arrest without ST-Segment Elevation.” New England Journal of Medicine, vol. 381, no. 2, Nov. 2019, pp. 188–190., doi:10.1056/nejmc1906523.</ref>
*Aggressively treat [[hyperglycemia]]
**No IV fluids with glucose
**RISS
*Aggressive [[seizure]] treatment
**Prophylaxis unproven
**AHA recommends EEG for comatose patients<ref>Callaway CW, Donnino MW, Fink EL, et al. Part 8: post-cardiac arrest care: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 Suppl 2):S465–82.</ref>
**If epileptiform activity present, treat as you would other patients with [[seizure]]
*Minimize Irritation
**[[Sedation|Sedatives]] +/- paralytics
**Supine positioning

==Prognostication<ref>Breu AC. Clinician-Patient Discussions of Successful CPR—The Vegetable Clause. JAMA Intern Med. 2018;178(10):1299–1300. doi:10.1001/jamainternmed.2018.4066</ref>==
*Out-of-hospital cardiac arrest (OHCA) has about a 10% survival to discharge rate
*In-hospital cardiac arrest has just over a 20% survival to discharge rate
**About half will have no to mild disability, and the other half will have moderate to severe disability
*Lack of pupillary reflexes upon ROSC after OHCA are not reliable in prognosticating return of neurologic function
*Recommended to wait minimum of 72 hours post-ROSC for prognostication

==See Also==
*[[ACLS (Main)]]
*[[Adult Cardiac Arrest]]

==References==
<references/>

[[Category:Cardiology]]