Copyright © 2010 American Heart Association. All rights reserved. Print ISSN: 0009-7322. Online
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Silvers, Arno L. Zaritsky, Raina Merchant, Terry L. Vanden Hoek and Steven L.
Geocadin, Janice L. Zimmerman, Michael Donnino, Andrea Gabrielli, Scott M.
Mary Ann Peberdy, Clifton W. Callaway, Robert W. Neumar, Romergryko G. for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Part 9: PostCardiac Arrest Care: 2010 American Heart Association Guidelines http://circ.ahajournals.org/cgi/content/full/122/18_suppl_3/S768 located on …ver más…
8,9 Because multiple organ systems are affected after cardiac arrest, successful post–cardiac arrest care will benefit from the development of system-wide plans for proactive treatment of these patients. For example, restoration of blood pressure and gas exchange does not ensure survival and functional recovery.
Significant cardiovascular dysfunction can develop, requiring support of blood flow and ventilation, including intravascular volume expansion, vasoactive and inotropic drugs, and invasive devices. Therapeutic hypothermia and treatment of the underlying cause of cardiac arrest impacts survival and neurological outcomes. Protocolized hemodynamic optimization and multidisciplinary early goal-directed therapy protocols have been introduced as part of a bundle of care to improve survival rather than single interventions.10–12 The data suggests that proactive titration of post–cardiac arrest hemodynamics to levels intended to ensure organ perfusion and oxygenation may improve outcomes.
There are multiple specific options for acheiving these goals, and it is difficult to distinguish between the benefit of protocols or any specific component of care that is most important. A comprehensive, structured, multidisciplinary system of care should be implemented in a consistent manner for the treatment of post– cardiac arrest patients (Class I, LOE B).
Programs should include as part of