Abstract
The formalizing post resuscitation care to include therapeutic hypothermia and cardiac angiography with percutaneous coronary intervention when needed could significantly improve survival following cardiac arrest. Any sudden death patient suspected to have a cardiac origin for their cardiac arrest should be considered for early catheterization and subsequent percutaneous coronary intervention (PCI) if a culprit lesion can be identified. Successful PCI improves survival to hospital discharge and cerebral performance category in patients with or without ST elevation. Current ‘report carding’ methodology needs to be changed regarding those resuscitated from cardiac arrest (patients with cardiac arrest not including them in any statistical reporting on PCI mortality report cards).
Highlights
Recent changes in several community resuscitation programs have resulted in improved outcomes. [1,2,3,4] Such changes have emphasized chest compression-only bystander basic life support and a renewed emphasis on uninterrupted, forceful chest compressions during professionally-performed cardiopulmonary resuscitation (CPR)
Post Resuscitation Coronary Angiography and Intervention. The success of this more formalized and aggressive post resuscitation care approach spawned a number of important questions regarding early catheterization and percutaneous coronary intervention (PCI) after cardiac arrest, namely 1) who should undergo such, 2) when should it be done, and 3) does it truly improve outcome? Many interventional cardiologists are currently reluctant to perform coronary angiography and subsequent intervention on those with altered states of consciousness post cardiac arrest fearing long-term central nervous system disability
The data for rapid induction of mild hypothermia combined with emergent coronary angiography and PCI is convincing for ST elevation myocardial infarction (STEMI) patients successfully resuscitated from cardiac arrest
Summary
Recent changes in several community resuscitation programs have resulted in improved outcomes. [1,2,3,4] Such changes have emphasized chest compression-only bystander basic life support and a renewed emphasis on uninterrupted, forceful chest compressions during professionally-performed cardiopulmonary resuscitation (CPR). [1,2,3,4] Such changes have emphasized chest compression-only bystander basic life support and a renewed emphasis on uninterrupted, forceful chest compressions during professionally-performed cardiopulmonary resuscitation (CPR) During this same period the importance of aggressive post resuscitation care has been recognized. [5] Sunde et al found an historical postresuscitation mortality rate of 74% at their hospital They began a program of formalized in-hospital post-resuscitation care, including the use of mild (32-34 °C) therapeutic hypothermia and early cardiac catheterization with percutaneous coronary intervention (PCI) for appropriate lesions. After instituting this more aggressive post-resuscitation care their one-year survival rate increased to 56%. The decision to perform cardiac catheterization post resuscitation was left to the treating physician based on the likelihood of a cardiac etiology for the cardiac arrest
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
