Intensive care after cardiac arrest

Cardiac arrest causes an abrupt cessation of circulation, which rapidly leads to global ischaemia and hypoxia. Immediate and competent care is vital, and even when the circulation has been restored, there is a profound risk of patients never regaining consciousness due to hypoxic-ischaemic brain injury, or death due recurrent cardiac arrest or multiorgan failure. The complex pattern of symptoms seen in resuscitated cardiac arrest patients has been termed post-cardiac arrest syndrome and encompasses brain injury, myocardial dysfunction, systemic ischaemia and reperfusion response, and the pathological process that caused the cardiac arrest. This educational review describes the intensive care for resuscitated cardiac arrest patients and provides discussions of current evidence and emerging trends for key therapeutic areas.