13. Post-resuscitation care

Question 1

What are the components of post-cardiac arrest syndrome?

Answer 1

1. post-cardiac arrest brain injury
2. post-cardiac arrest mycardial dynsfunction
3. systemic ischaemia/reperfusion response
4. persistent precipitating pathology

Question 2

What is the algorithm for post-resuscitation care?

Answer 2

Question 3

What investigations should be carried out post-resuscitation?

Answer 3

Question 4

What is the treatment for post-resuscitation cardiac dysfunction?

Answer 4

• Noradrenaline +/- dobutaine
• IV fluids
• Intra-aortic balloon pump

Question 5

Which patients should be referred for consideration of ICD post-arrest?

Answer 5

Patients who have been resuscitated from shockable rhythm outside of STEMI

Question 6

What percentage of ICU patients suffer from seizures post-cardiac arrest?

Answer 6

20-30%

Question 7

Is there any indication for prophylactic medication in post-arrest seizure prevention?

Answer 7

No, only those with diagnosis of seizures should be treated

Question 8

How should glucose be controlled post-arrest?

Answer 8

Between 4-10 mmol/L

Question 9

What temperatures should post-arrest patients be maintained at?

Answer 9

32-36C

Question 10

How can Targeted Temperature Management (TTM) be achieved in-hospital?

Answer 10

• Ice packs/towels
• Cooling blankets
• Water-circulating gel-coated pads
• Transnasal evaporative cooling
• Intravascular heat exchanger
• ECMO

Question 11

Should pre-hospital TTM be carried out?

Answer 11

No, increases risk of pulmonary oedema

Question 12

What should be the rate of rewarming following TTM in post-arrest patients?

Answer 12

0.25-0.5C per hour