Management of postcardiac arrest myocardial dysfunction

Ayhan Zia, Karl B Kern

Research output: Contribution to journalReview article

23 Citations (Scopus)

Abstract

Purpose of review: Recent recognition of the importance of postresuscitation care has stimulated interest and new reports concerning therapies for postcardiac arrest myocardial dysfunction. Such cardiac dysfunction after successful resuscitation can be severe and even lethal; however, it is also transient emphasizing the importance of early supportive therapies. Recent findings: The most important strategies for dealing with postresuscitation myocardial dysfunction include a community-formalized effort by individual communities to shorten the time from arrest to restoration of spontaneous circulation, use of therapeutic hypothermia for myocardial preservation, not just cerebral, and early coronary angiography and intervention for all survivors with a high suspicion of a cardiac cause for their arrest. Exciting specific therapies targeted for one or another of the ischemia/reperfusion myocardial injuries associated with cardiac arrest include manipulation of the nitric oxide production in the myocardium, treatment of myocardial microcirculatory dysfunction post resuscitation, inhibition of Na+/H+ exchange, and treatment of calcium flux abnormalities. Summary: Every community should be striving to provide more timely restoration of pulse and circulation, whereas every medical center receiving patients resuscitated from out-of-hospital cardiac arrest should be providing therapeutic hypothermia for both central nervous system and myocardial preservation. The ability and commitment to provide '24/7' early coronary angiography and percutaneous intervention for all resuscitated victims of sudden cardiac death with a likely cardiac cause for their arrest is also key.

Original languageEnglish (US)
Pages (from-to)241-246
Number of pages6
JournalCurrent Opinion in Critical Care
Volume17
Issue number3
DOIs
StatePublished - 2011

Fingerprint

Induced Hypothermia
Coronary Angiography
Resuscitation
Out-of-Hospital Cardiac Arrest
Sudden Cardiac Death
Therapeutics
Secondary Prevention
Heart Arrest
Reperfusion Injury
Survivors
Pulse
Myocardium
Nitric Oxide
Central Nervous System
Calcium

Keywords

  • global myocardial stunning
  • myocardial dysfunction after cardiac arrest
  • postresuscitation syndrome

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Management of postcardiac arrest myocardial dysfunction. / Zia, Ayhan; Kern, Karl B.

In: Current Opinion in Critical Care, Vol. 17, No. 3, 2011, p. 241-246.

Research output: Contribution to journalReview article

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