Importance of invasive interventional strategies in resuscitated patients following sudden cardiac arrest

Abstract

Post-resuscitation care has become a major part of the chain of survival for victims of cardiac arrest. Once spontaneous circulation is restored, it is important to consider early coronary angiography and concurrent use of mild therapeutic hypothermia. In those resuscitated from an arrest considered to be cardiac in origin, coronary angiography should be performed inmmediately to identify any culprit coronary occlusion or unstable lesions. If a culprit lesion is found, immediate percutaneous coronary intervention should be performed. Any out-of-hospital cardiac arrest victim successfully resuscitated, but who remain comatose after return of spontaneous circulation, should be cooled to 32–24°C for 24 h. Induction of mild hypothermia can be accomplished without delaying coronary intervention. When these two post-resuscitation therapies are provided concurrently long-term survival is 50–60%, with favorable neurological function achieved in 80–90% of such survivors.