Advances in the hospital management of patients following an out of hospital cardiac arrest
- Jerry P Nolan1,
- Richard M Lyon2,
- Comilla Sasson3,
- Andrea O Rossetti4,
- Alexandra J Lansky5,
- Keith A A Fox6,
- Pascal Meier7
- 1Department of Anaesthesia and Intensive Care Medicine, Royal United Hospital, Bath, UK
- 2London Air Ambulance, London, UK
- 3Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
- 4Département des Neurosciences Cliniques, CHUV and University of Lausanne, Lausanne, Switzerland
- 5Yale Cardiovascular Research Group, Yale Medical School, New Haven, Connecticut, USA
- 6Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
- 7The Heart Hospital London, University College London, London, UK
- Correspondence to Dr Pascal Meier, Director Yale, UCL Device Development Program, The Heart Hospital London, University College London Hospital Trust, London, UK; pascalmeier74{at}gmail.com
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Contributors All coauthors contributed substantially to this manuscript; all authors have read and approved the final version of the manuscript.
- Received 25 October 2011
- Revised 28 April 2012
- Accepted 30 April 2012
- Published Online First 30 May 2012
Abstract
The outcome for patients after an out-of-hospital cardiac arrest (OHCA) has been poor over many decades and single interventions have mostly resulted in disappointing results. More recently, some regions have observed better outcomes after redesigning their cardiac arrest pathways. Optimised resuscitation and prehospital care is absolutely key, but in-hospital care appears to be at least as important. OHCA treatment requires a multidisciplinary approach, comparable to trauma care; the development of cardiac arrest pathways and cardiac arrest centres may dramatically improve patient care and outcomes. Besides emergency medicine physicians, intensivists and neurologists, cardiologists are playing an increasingly crucial role in the post-resuscitation management, especially by optimising cardiac output and undertaking urgent coronary angiography/intervention.
- Cardiac arrest
- resuscitation
- hypothermia
- post-arrest management
- angiography, anaesthetics
- intensive care
- emergency medicine
- neurology
- acute coronary syndrome
- reperfusion
- NSTEMI
- angina—unstable
- atherosclerosis
- coronary collateral circulation
- coronary intervention (PCI)
- coronary stenting
- carotid stenting
Footnotes
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Competing interests None.
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Provenance and peer review Commissioned; externally peer reviewed.
