Reynolds Joshua C, Lawner Benajmin J
Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
J Emerg Med. 2012 Apr;42(4):440-9. doi: 10.1016/j.jemermed.2011.09.026. Epub 2012 Jan 27.
Recent advances in resuscitation science have revolutionized care of the cardiac arrest patient. Dramatic departures from time-honored advanced cardiac life support therapies, such as cardiocerebral resuscitation and bundled post-arrest care, have given rise to a new paradigm of resuscitation practices, which has boosted the rate of neurologically intact survival.
This article reviews the pathophysiology of the post-cardiac arrest syndrome, the collective pathophysiology after return of spontaneous circulation, and presents management pearls specifically for the emergency physician. This growing area of scientific inquiry must be managed appropriately to sustain improved outcomes.
The emergency physician must understand this pathophysiology, manage resuscitated patients according to the latest evidence, and coordinate with appropriate inpatient resources.
The new approach to cardiac arrest care is predicated on a chain of survival that spans the spectrum of care from the prehospital arena through the emergency, intensive, and inpatient settings. The emergency physician is a crucial link in this chain.
复苏科学的最新进展彻底改变了心脏骤停患者的护理方式。与历史悠久的高级心脏生命支持疗法有显著差异，如心肺复苏和心脏骤停后综合护理，催生了一种新的复苏实践模式，提高了神经功能完好存活的比例。
本文回顾心脏骤停后综合征的病理生理学、自主循环恢复后的总体病理生理学，并为急诊医生提供具体的管理要点。必须妥善管理这一不断发展的科学研究领域，以维持改善的治疗效果。
急诊医生必须了解这种病理生理学，根据最新证据管理复苏后的患者，并与适当的住院资源进行协调。
心脏骤停护理的新方法基于一条生存链，该生存链涵盖从院前领域到急诊、重症和住院环境的整个护理范围。急诊医生是这条链中的关键环节。
