Cardiac arrest and post‑cardiac arrest care

Czech version

Authors: A. Krüger
Authors‘ workplace: Kardiocentrum, Nemocnice Na Homolce, Praha
Published in: Kardiol Rev Int Med 2015, 17(3): 230-233
Category: Cardiology Review

Overview

Out‑ of‑ hospital cardiac arrest occurs in 35– 40 persons per 100,000 inhabitants per year. The rate of in‑hospital cardiac arrests is 1– 5 for 1,000 hospitalisations per year. The probability of survival prior to hospital discharge is approximately 10% in out‑ of‑ hospital arrests; this doubles in cases of ventricular fibrillation as the initial rhythm. For in‑hospital cardiac arrests the probability of survival is slightly higher at 15– 20%, again with better chances for a shockable initial rhythm (ventricular fibrillation/ tachycardia). Patient survival with a good neurological outcome is strongly dependent on immediate initiation of cardiopulmonary resuscitation and high quality post‑cardiac arrest care.

Keywords:
cardiac arrest – mild therapeutic hypothermia – extracorporeal resuscitation

Sources

1. Rubertsson SE, Lindgren E, Smekal D et al. Mechanical chest compressions and simultaneous defibrillation vs conventional cardiopulmonary resuscitation in out‑ of‑ hospital cardiac arrest: the LINC randomized trial. JAMA 2014; 311: 53– 61. doi: 10.1001/ jama.2013.282538.

2. Wang CH, Chou NK, Becker LB et al. Improved outcome of extracorporeal cardiopulmonary resuscitation for out‑ of‑ hospital cardiac arrest‑ a comparison with that for extracorporeal rescue for in‑hospital cardiac arrest. Resuscitation 2014; 85: 1219– 1224. doi: 10.1016/ j.resuscitation.2014.06.022.

3. Lin JW, Wang MJ, Yu HY et al. Comparing the survival between extracorporeal rescue and conventional resuscitation in adult in‑hospital cardiac arrests: propensity analysis of three‑year data. Resuscitation 2010; 81: 796– 803. doi: 10.1016/ j.resuscitation.2010.03.002.

4. Chou TH, Fang CC, Yen ZS et al. An observational study of extracorporeal CPR for in‑hospital cardiac arrest secondary to myocardial infarction. Emerg Med J 2014; 31: 441– 447. doi: 10.1136/ emermed‑ 2012‑ 202173.

5. Hypothermia after Cardiac Arrest Study Group. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 2002; 346: 549– 556.

6. Bernard SA, Gray TW, Buist MD at al. Treatment of comatose survivors of out‑ of‑ hospital cardiac arrest with induced hypothermia. N Engl J Med 2002; 346: 557– 563.

7. Nielsen N, Wetterslev J, Cronberg T et al. Target temperature management at 33 °C versus 36 °C after cardiac arrest. N Engl J Med 2013; 369: 2197– 2206. doi: 10.1056/ NEJMoa1310519.