Management of Post-Resuscitative Era in Patients with Cardiac Arrest: Post-Cardiac Arrest Syndrome

Cardiac arrest (CA) resulting from sudden cardiac death and acute coronary syndromes affects many people every day all over the world. Post-cardiac arrest syndrome (PCAS) encompasses post-CA brain injury, myocardial dysfunction, reperfusion injury, and the continuation of the causative event, as a complex and critical issue that requires multidisciplinary intervention. Successful intervention in these cases can only be achieved with advanced cardiac life support (ACLS) management to provide the return of spontaneous circulation (ROSC). Favorable neurological outcome targets have been established in recent decades and some progress has been made despite many uncertainties still exist. Optimization of oxygenation and hemodynamics, early coronary interventions, ACLS, and early and intensive management of targeted temperature management (TTM) has been reported to positively affect survival with fewer neurological sequelae in patients with ROSC. Institution of extracorporeal cardiopulmonary resuscitation (eCPR) initiated within 50 min of collapse, and combination of TTM with eCPR were advocated as predictors of favorable prognosis. In this study, efforts to provide the best outcomes after CA and related advances are described.