Developments in post-resuscitation care for out-of-hospital cardiac arrests in adults - a narrative review

This review focuses on current developments in post-resuscitation care for adults with an out-of-hospital cardiac arrest (OHCA). As the incidence of OHCA is high and with a low percentage of survival, it remains a challenge to treat those who survive the initial phase and regain spontaneous circulat...

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Main Authors: Katzenschlager, Stephan (Author) , Popp, Erik (Author) , Wnent, Jan (Author) , Weigand, Markus A. (Author) , Gräsner, Jan-Thorsten (Author)
Format: Article (Journal)
Language:English
Published: 20 April 2023
In: Journal of Clinical Medicine
Year: 2023, Volume: 12, Issue: 8, Pages: 1-11
ISSN:2077-0383
DOI:10.3390/jcm12083009
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.3390/jcm12083009
Verlag, kostenfrei, Volltext: https://www.mdpi.com/2077-0383/12/8/3009
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Author Notes:Stephan Katzenschlager, Erik Popp, Jan Wnent, Markus A. Weigand and Jan-Thorsten Gräsner

MARC

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520 |a This review focuses on current developments in post-resuscitation care for adults with an out-of-hospital cardiac arrest (OHCA). As the incidence of OHCA is high and with a low percentage of survival, it remains a challenge to treat those who survive the initial phase and regain spontaneous circulation. Early titration of oxygen in the out-of-hospital phase is not associated with increased survival and should be avoided. Once the patient is admitted, the oxygen fraction can be reduced. To maintain an adequate blood pressure and urine output, noradrenaline is the preferred agent over adrenaline. A higher blood pressure target is not associated with higher rates of good neurological survival. Early neuro-prognostication remains a challenge, and prognostication bundles should be used. Established bundles could be extended by novel biomarkers and methods in the upcoming years. Whole blood transcriptome analysis has shown to reliably predict neurological survival in two feasibility studies. This needs further investigation in larger cohorts. 
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