Top Things to Know: Post Cardiac Arrest Syndrome

Published: October 23, 2008

  1. Approximately 166,200 out-of-hospital cardiac arrests occur annually in the US.
  2. On average, approximately 6.4% of out-of-hospital cardiac arrest victims survive to hospital discharge.
  3. The in-hospital mortality rate of patients who achieve return of spontaneous circulation after cardiac arrest has not changed significantly over the past half-century.
  4. There is growing evidence that appropriate post-cardiac arrest care, such as tight blood glucose control and therapeutic hypothermia, can improve mortality rate and functional outcome.
  5. Post–cardiac arrest brain injury is a common cause of morbidity and mortality.
  6. Post-cardiac arrest syndrome is characterized by resumption of spontaneous circulation after prolonged complete whole body ischemia.
  7. Hyperglycemia is common in post–cardiac arrest patients and is associated with poor neurological outcome.
  8. Post–cardiac arrest myocardial dysfunction can contribute to low survival rates after in- and out-of-hospital cardiac arrest but is both responsive to therapy and reversible.
  9. It is appropriate to consider immediate coronary angiography in all post– cardiac arrest patients in whom ACS is suspected. Cardiac arrest patients with STEMI ECG criteria should undergo immediate coronary angiography and subsequent PCI if indicated; thrombolytic therapy can be an appropriate alternative if PCI is not available.
  10. Both preclinical and clinical evidence strongly support mild therapeutic hypothermia as an effective therapy for the post–cardiac arrest syndrome.