Royal United Hospital, Bath, UK.
Curr Opin Crit Care. 2010 Jun;16(3):216-22. doi: 10.1097/MCC.0b013e3283383dca.
The purpose of this study is to discuss recent data relating to the treatment of cardiac arrest survivors. This is a rapidly evolving component of resuscitation medicine that impacts significantly on the quality of survival after cardiac arrest.
The postcardiac arrest syndrome comprises postcardiac arrest brain injury, postcardiac arrest myocardial dysfunction, the systemic ischaemia/reperfusion response, and the persistent precipitating disease. Primary percutaneous coronary intervention is the preferred method for restoring coronary perfusion when cardiac arrest has been caused by an ST-elevation myocardial infarction. Many cardiac arrest survivors with non-ST-elevation myocardial infarction may also benefit from urgent percutaneous coronary intervention. Comatose cardiac arrest survivors should be managed with a moderate blood glucose target range of below 10 mmol/l (180 mg/dl). Therapeutic hypothermia is now generally accepted as part of a treatment strategy for comatose survivors of cardiac arrest, but its use may render conventional methods of prognostication unreliable.
Survivors from cardiac arrest develop a postcardiac arrest syndrome. Postresuscitation care, including primary percutaneous coronary intervention, therapeutic hypothermia, and control of blood sugar, improves survival and neurological outcome in cardiac arrest survivors. Completely reliable prognostication in comatose survivors of cardiac arrest is difficult to achieve.
本研究旨在讨论与心搏骤停幸存者治疗相关的最新数据。这是复苏医学中一个快速发展的领域，对心搏骤停后生存质量有重大影响。
心搏骤停后综合征包括心搏骤停后脑损伤、心搏骤停后心肌功能障碍、全身性缺血/再灌注反应和持续的诱发疾病。当心搏骤停由 ST 段抬高型心肌梗死引起时，经皮冠状动脉介入治疗是恢复冠状动脉灌注的首选方法。许多非 ST 段抬高型心肌梗死的心搏骤停幸存者也可能从紧急经皮冠状动脉介入治疗中获益。昏迷的心搏骤停幸存者的血糖目标范围应控制在 10mmol/L（180mg/dl）以下。亚低温治疗目前已被普遍接受为昏迷的心搏骤停幸存者的治疗策略的一部分，但它的使用可能使传统的预后判断方法变得不可靠。
心搏骤停幸存者会发展为心搏骤停后综合征。复苏后治疗，包括经皮冠状动脉介入治疗、亚低温治疗和血糖控制，可改善心搏骤停幸存者的生存和神经预后。昏迷的心搏骤停幸存者的完全可靠预后判断较为困难。
