Optimizing outcome after cardiac arrest.
Current Opinion in Critical Care · 2011-07-12 · Other / unclear
Abstract
PURPOSE OF REVIEW: To discuss recent data relating to survival rates after cardiac arrest and interventions that can be used to optimize outcome. RECENT FINDINGS: A recent analysis of 70 studies indicates that following out-of-hospital cardiac arrest (OHCA), 7.6% of patients will survive to hospital discharge (95% confidence interval 6.7-8.4). Following in-hospital cardiac arrest, 18% of patients will survive to hospital discharge. Survival may be optimized by increasing the rate of bystander cardiopulmonary resuscitation (CPR), which can be achieved by improving recognition of cardiac arrest, simplifying CPR and training more of the community. Feedback systems improve the quality of CPR but this has yet to be translated into improved outcome. One study has shown improved survival following OHCA with active compression-decompression CPR combined with an impedance-threshold device. In those who have no obvious extracardiac cause of OHCA, 70% have at least one significant coronary lesion demonstrable by coronary angiography. Although generally reserved for those with ST-elevation myocardial infarction, primary percutaneous coronary intervention may also benefit OHCA survivors with ECG patterns other than ST elevation. The term 'mild therapeutic hypothermia' has been replaced by the term 'targeted temperature management'; its role in optimizing outcome after cardiac arrest continues to be defined. SUMMARY: In several centres, survival rates following OHCA are increasing. All links in the chain of survival must be optimized if a good-quality neurological outcome is to be achieved.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Bystanders · CPR adjuncts · CPR feedback devices · Mortality & survival · Quality of life & function · Temperature management
Related articles
- Rethinking cardiac arrest: new paradigms in the 2025 ERC guidelines. (Hellenic J Cardiol, 2026)
- Part 1: Executive Summary: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. (Circulation, 2025)
- Rationale and Strategies for Development of an Optimal Bundle of Management for Cardiac Arrest. (Crit Care Explor, 2020)
- Cardiocerebral resuscitation: a better approach to cardiac arrest. (Curr Opin Cardiol, 2008)
- Predictors of survival and favorable neurological outcome in patients treated with targeted temperature management after cardiac arrest: A systematic review and meta-analysis. (Heart Lung, 2018)
- A Study on the Outcome of Targeted Temperature Management Comparing Cardiac Arrest Patients Who Received Bystander Cardiopulmonary Resuscitation With Those Who Did Not, Using the Nationwide TIMECARD Multicenter Registry. (Front Med (Lausanne), 2022)