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The 2013 ILCOR and 2010 American Heart Association guidelines support the use of cooling following resuscitation from cardiac arrest. [1] [7] These recommendations were largely based on two trials from 2002 which showed improved survival and brain function when cooled to 32–34 °C (90–93 °F) after cardiac arrest.
Researchers analyzed data from 259 women and 996 men in the Netherlands who survived at least 30 days after a cardiac arrest that took place outside a hospital between 2009 and 2015.
Before cardiac arrest, the body is in a state of homeostasis. Arterial blood circulates appropriately through the body, supplying oxygen to tissues while the venous blood collects metabolic waste products to be utilized elsewhere and/or eliminated from the body. However, during cardiac arrest, the body is in circulatory and pulmonary arrest ...
According to the American Heart Association, out-of-hospital cardiac arrest can affect more than 300,000 people in the United States each year. [5] Three minutes after the onset of cardiac arrest, a lack of blood flow starts to damage the brain, and 10 minutes after, the chances of survival are low. [6]
One study showed that those who had had an out-of-hospital cardiac arrest and had achieved return of spontaneous circulation, 38% of those people had a cardiac re-arrest before arriving at the hospital with an average time of 3 minutes to re-arrest. [8] Patients with sustained ROSC generally present with post-cardiac arrest syndrome (PCAS ...
Current international guidelines suggest cooling adults after cardiac arrest using targeted temperature management (TTM) with the goal of improving neurological outcomes. [123] The process involves cooling for a 24-hour period, with a target temperature of 32–36 °C (90–97 °F), followed by gradual rewarming over the next 12 to 24 hrs.
Per current guidelines (e.g., the ESC guidelines from 2015 and 2021) a patient has to wait at least 40 to 90 days after the cardiac event (e.g., myocardial infarction or newly diagnosed heart failure with reduced left ventricular function) before the decision to implant an ICD should be made. [21]
With the advent of these strategies, cardiac arrest came to be called clinical death rather than simply death, to reflect the possibility of post-arrest resuscitation. At the onset of clinical death, consciousness is lost within several seconds, and in dogs, measurable brain activity has been measured to stop within 20 to 40 seconds. [2]