Post-cardiopulmonary resuscitation management in the intensive care unit

Abstract

Since the introduction of modern cardiopulmonary resuscitation (CPR) and emergency cardiovascular care 50 years ago, considerable progress has been achieved in the management of cardiac arrest patients (1). Nevertheless, patients admitted to the intensive care unit (ICU) after successful resuscitation are at high risk for postresuscitation disease (2), a condition of multiple life-threatening disorders, including neurologic failure. Despite advances in cardiac arrest resuscitation, neurologic impairments and other organ dysfunctions cause considerable mortality and morbidity after restoration of spontaneous cardiac activity. Community-wide studies found mortality rates ranging from 4% to 33% depending on the chain of survival. Reports of higher survival rates in patients treated with mild hypothermia (3, 4) after successful cardiac arrest resuscitation confirm that the outcome is determined not only by the time to circulation recovery, but also by pathogenic processes that are triggered by the cardiac arrest but continue to evolve subsequently, causing damage to the nervous system and other organs. © 2008 Springer-Verlag London.