The urgent need for treatment does not end when a person regains a pulse after sudden cardiac arrest—healthcare providers need to move quickly into post-cardiac arrest care to keep a person alive and ensure the best outcome, according to American Heart Association (AHA) science advisory published today in Circulation.
The largest modern report of cardiac arrest resuscitation was published by the National Registry of CPR in 2006. Among the 19,819 adults and 524 children whose hearts were re-started, in-hospital mortality rates were 67 percent and 55 percent, respectively.
The new statement states that there is growing evidence that post-cardiac arrest care can lower the death rate and improve functional outcome for these patients.
“Although we have become better at restarting the heart, we are only beginning to learn and implement the best ways to keep patients alive and minimize brain damage after their heart is re-started,” said Robert W. Neumar, MD, PhD, head of the statement writing committee, associate professor of emergency medicine and associate director of the Center for Resuscitation Science at the University of Pennsylvania in Philadelphia.
The research shows that many aspects of post-cardiac arrest syndrome can be treated. The advisory discussed treatments for various types of patients such as:
- Unconscious adult patients resuscitated after out-of-hospital cardiac arrest were recommended to receive mild therapeutic hypothermia, which is cooling to 89.6°F to 93.2°F for at least 12 to 24 hours. Therapeutic hypothermia can improve survival and decrease the risk of brain damage.
- Patients resuscitated from a cardiac arrest caused by a heart attack (as seen on an ECG) should have immediate coronary angiography to check for artery blockages. Standard guidelines for heart attack treatment should be followed, which may include an angioplasty or administering a clot-busting drug to re-establish blood flow to the heart.
The advisory also discussed treatment for high blood sugar, seizures and infection, all of which are common concerns after cardiac arrest resuscitation. Also, inserting an implantable cardioverter defibrillator (ICD) is indicated for many patients with good neurological function.