Top

Published in:

Open Access 01-02-2019 | Editorial

Physiological interventions in cardiac arrest: passing the pilot phase

Authors: Niklas Nielsen, Alain Cariou, Christian Hassager

Published in: Intensive Care Medicine | Issue 2/2019

Excerpt

The damaging processes leading to a poor outcome after cardiac arrest start at the onset of ischemia and continues during the reperfusion phase. Intensive care treatment in resuscitated patients relies on organ support restoring normal physiology with attention to brain protection. Drugs have not proven beneficial in randomised trials. To date induced hypothermia, or targeted temperature management (TTM), is the only specific intervention implemented in clinical practice. Nevertheless, its final role and configuration are still under debate and are currently being investigated. …

Oksanen T, Skrifvars MB, Varpula T, Kuitunen A, Pettila V, Nurmi J, Castren M (2007) Strict versus moderate glucose control after resuscitation from ventricular fibrillation. Intensive Care Med 33:2093–2100CrossRefPubMed

Elmer J, Scutella M, Pullalarevu R, Wang B, Vaghasia N, Trzeciak S, Rosario-Rivera BL, Guyette FX, Rittenberger JC, Dezfulian C, Pittsburgh Post-Cardiac Arrest Service (PCAS) (2015) The association between hyperoxia and patient outcomes after cardiac arrest: analysis of a high-resolution database. Intensive Care Med 41:49–57CrossRefPubMed

Roberts BW, Kilgannon JH, Hunter BR, Puskarich MA, Shea L, Donnino M, Jones C, Fuller BM, Kline JA, Jones AE, Shapiro NI, Abella BS, Trzeciak S (2018) Association between elevated mean arterial blood pressure and neurologic outcome after resuscitation from cardiac arrest: results from a multicenter prospective cohort study. Crit Care Med. https://doi.org/10.1097/CCM.0000000000003474

Vaahersalo J, Bendel S, Reinikainen M, Kurola J, Tiainen M, Raj R, Pettila V, Varpula T, Skrifvars MB, FINNRESUSCI Study Group (2014) Arterial blood gas tensions after resuscitation from out-of-hospital cardiac arrest: associations with long-term neurologic outcome. Crit Care Med 42:1463–1470CrossRefPubMed

Bro-Jeppesen J, Annborn M, Hassager C, Wise MP, Pelosi P, Nielsen N, Erlinge D, Wanscher M, Friberg H, Kjaergaard J, TTM Investigators (2015) Hemodynamics and vasopressor support during targeted temperature management at 33 degrees C versus 36 degrees C after out-of-hospital cardiac arrest: a post hoc study of the target temperature management trial. Crit Care Med 43:318–327CrossRefPubMed

McKenzie N, Williams TA, Tohira H, Ho KM, Finn J (2017) A systematic review and meta-analysis of the association between arterial carbon dioxide tension and outcomes after cardiac arrest. Resuscitation 111:116–126CrossRefPubMed

Roberts BW, Kilgannon JH, Hunter BR, Puskarich MA, Pierce L, Donnino M, Leary M, Kline JA, Jones AE, Shapiro NI, Abella BS, Trzeciak S (2018) Association between early hyperoxia exposure after resuscitation from cardiac arrest and neurological disability: prospective multicenter protocol-directed cohort study. Circulation 137:2114–2124CrossRefPubMedPubMedCentral

Ebner F, Harmon MBA, Aneman A, Cronberg T, Friberg H, Hassager C, Juffermans N, Kjaergaard J, Kuiper M, Mattsson N, Pelosi P, Ullen S, Unden J, Wise MP, Nielsen N (2018) Carbon dioxide dynamics in relation to neurological outcome in resuscitated out-of-hospital cardiac arrest patients: an exploratory target temperature management trial substudy. Crit Care 22:196CrossRefPubMedPubMedCentral

Eastwood GM, Schneider AG, Suzuki S, Peck L, Young H, Tanaka A, Martensson J, Warrillow S, McGuinness S, Parke R, Gilder E, McCarthy L, Galt P, Taori G, Eliott S, Lamac T, Bailey M, Harley N, Barge D, Hodgson CL, Morganti-Kossmann MC, Pebay A, Conquest A, Archer JS, Bernard S, Stub D, Hart GK, Bellomo R (2016) Targeted therapeutic mild hypercapnia after cardiac arrest: a phase II multi-centre randomised controlled trial (the CCC trial). Resuscitation 104:83–90CrossRefPubMed

10.

Johnston AJ, Steiner LA, Gupta AK, Menon DK (2003) Cerebral oxygen vasoreactivity and cerebral tissue oxygen reactivity. Br J Anaesth 90:774–786CrossRefPubMed

11.

Ameloot K, De Deyne C, Ferdinande B, Dupont M, Palmers PJ, Petit T, Eertmans W, Moonen C, Belmans A, Lemmens R, Dens J, Janssens S (2017) Mean arterial pressure of 65 mm Hg versus 85–100 mm Hg in comatose survivors after cardiac arrest: rationale and study design of the Neuroprotect post-cardiac arrest trial. Am Heart J 191:91–98CrossRefPubMed

12.

Stammet P, Collignon O, Hassager C, Wise MP, Hovdenes J, Aneman A, Horn J, Devaux Y, Erlinge D, Kjaergaard J, Gasche Y, Wanscher M, Cronberg T, Friberg H, Wetterslev J, Pellis T, Kuiper M, Gilson G, Nielsen N, TTM-Trial Investigators (2015) Neuron-specific enolase as a predictor of death or poor neurological outcome after out-of-hospital cardiac arrest and targeted temperature management at 33 degrees C and 36 degrees C. J Am Coll Cardiol 65:2104–2114CrossRefPubMed

13.

Ramont L, Thoannes H, Volondat A, Chastang F, Millet MC, Maquart FX (2005) Effects of hemolysis and storage condition on neuron-specific enolase (NSE) in cerebrospinal fluid and serum: implications in clinical practice. Clin Chem Lab Med 43:1215–1217CrossRefPubMed

14.

Petinos P, Gay S, Badrick T (2015) Variation in laboratory reporting of haemolysis—a need for harmonisation. Clin Biochem Rev 36:133–137PubMedPubMedCentral

15.

Moseby-Knappe M, Mattsson N, Nielsen N, Zetterberg H, Blennow K, Dankiewicz J, Dragancea I, Friberg H, Lilja G, Insel PS, Rylander C, Westhall E, Kjaergaard J, Wise MP, Hassager C, Kuiper MA, Stammet P, Wanscher MCJ, Wetterslev J, Erlinge D, Horn J, Pellis T, Cronberg T (2018) Serum neurofilament light chain for prognosis of outcome after cardiac arrest. JAMA Neurol. https://doi.org/10.1001/jamaneurol.2018.3223

16.

Young P, Bailey M, Bellomo R, Bernard S, Dicker B, Freebairn R, Henderson S, Mackle D, McArthur C, McGuinness S, Smith T, Swain A, Weatherall M, Beasley R (2014) HyperOxic Therapy OR NormOxic Therapy after out-of-hospital cardiac arrest (HOT OR NOT): a randomised controlled feasibility trial. Resuscitation 85:1686–1691CrossRefPubMed

Title: Physiological interventions in cardiac arrest: passing the pilot phase
Authors: Niklas Nielsen
Alain Cariou
Christian Hassager
Publication date: 01-02-2019
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 2/2019
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-018-5492-2

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Physiological interventions in cardiac arrest: passing the pilot phase

Excerpt

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Excerpt

Please log in to get access to this content

Other articles of this Issue 2/2019

Is chloride worth its salt?

The ‘blinking frog’ ultrasound sign establishes the presence of pretracheal vasculature

Frugal innovation for critical care

Assessment of respiratory mechanics during pressure support ventilation? Caution required

Cerebral fat embolism after intraosseous infusion

Observational vs randomized: David vs Goliath for thromboprophylaxis in critically ill patients?