TY - JOUR
T1 - Postresuscitative Intensive Care
T2 - Neuroprotective strategies after cardiac arrest
AU - Wright, Wendy L.
AU - Geocadin, Romergryko G.
PY - 2006/9
Y1 - 2006/9
N2 - Cardiac arrest is a common disease in the United States, and many patients will die as a result of the neurological damage suffered during the anoxic period, or will live in a neurologically debilitated state. When cardiopulmonary-cerebral resuscitation results in the return of spontaneous circulation, intensive care is required to optimize neurological recovery. Such "brain-oriented" therapies include routine care, such as positioning and maintenance of volume status; optimization of cerebral perfusion, with the use of vasopressors if needed; management of increased intracranial pressure with agents such as hypertonic saline; assuring adequate oxygenation and avoiding hypercapnia; aggressive fever control; intensive glucose control, with the use of an insulin drip if needed; and management of seizures if they occur. To date, no neuroprotectant medications have been shown to improve neurological outcome. Induced moderate therapeutic hypothermia is utilized as a neuroprotective maneuver. Future treatment options and advanced monitoring techniques are also discussed. Further study to optimize neuroprotective strategies when treating patients who survive cardiac arrest is needed.
AB - Cardiac arrest is a common disease in the United States, and many patients will die as a result of the neurological damage suffered during the anoxic period, or will live in a neurologically debilitated state. When cardiopulmonary-cerebral resuscitation results in the return of spontaneous circulation, intensive care is required to optimize neurological recovery. Such "brain-oriented" therapies include routine care, such as positioning and maintenance of volume status; optimization of cerebral perfusion, with the use of vasopressors if needed; management of increased intracranial pressure with agents such as hypertonic saline; assuring adequate oxygenation and avoiding hypercapnia; aggressive fever control; intensive glucose control, with the use of an insulin drip if needed; and management of seizures if they occur. To date, no neuroprotectant medications have been shown to improve neurological outcome. Induced moderate therapeutic hypothermia is utilized as a neuroprotective maneuver. Future treatment options and advanced monitoring techniques are also discussed. Further study to optimize neuroprotective strategies when treating patients who survive cardiac arrest is needed.
KW - Cardiac arrest
KW - Cardiopulmonary-cerebral resuscitation (CPCR)
KW - Postresuscitation
UR - http://www.scopus.com/inward/record.url?scp=33747616900&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33747616900&partnerID=8YFLogxK
U2 - 10.1055/s-2006-948320
DO - 10.1055/s-2006-948320
M3 - Review article
C2 - 16969740
AN - SCOPUS:33747616900
SN - 0271-8235
VL - 26
SP - 396
EP - 402
JO - Seminars in neurology
JF - Seminars in neurology
IS - 4
ER -