Leiden University Medical Center.
Basalt Rehabilitation, Leiden.
Curr Opin Crit Care. 2019 Jun;25(3):240-243. doi: 10.1097/MCC.0000000000000609.
Most survivors of out-of-hospital cardiac arrest (OHCA) suffer from cardiologic symptoms and approximately half of them experience cognitive problems because of hypoxic brain damage. Symptoms of anxiety and depression are also common. This review aims to give an overview of recent literature on rehabilitation treatment aiming at improvement of quality of life after OHCA.
Existing cognitive screening tools are now validated for OHCA survivors. OHCA patients with cognitive deficits may have lower exercise capacity. Cardiac rehabilitation seems to be well tolerated for OHCA survivors, with outcomes comparable to myocardial infarction patients. Many caregivers suffer from posttraumatic stress disorder and emotional stress. Interventions for them are available. Implementation of integrated programs covering both cognitive and cardiac rehabilitation is hampered by lack of knowledge and organizational barriers.
OHCA survivors should be routinely screened for cognitive and emotional problems. When patients with mild cognitive deficits participate in cardiac rehabilitation, their program should be adjusted to their cognitive abilities. For patients with severe cognitive or emotional problems, individualized rehabilitation seems favorable. Integrated rehabilitation treatment between cardiac and cognitive rehabilitation departments is recommended. Attention should be paid to the burden of caregivers.
大多数院外心脏骤停（OHCA）幸存者有心脏症状，约一半幸存者因缺氧性脑损伤而出现认知问题。焦虑和抑郁症状也很常见。本文旨在综述 OHCA 后改善生活质量的康复治疗的最新文献。
目前已经有适合 OHCA 幸存者的认知筛查工具。存在认知缺陷的 OHCA 患者可能运动能力较低。心脏康复对 OHCA 幸存者的耐受性良好，结果与心肌梗死患者相当。许多护理人员患有创伤后应激障碍和情绪压力。已经有针对他们的干预措施。由于缺乏知识和组织障碍，涵盖认知和心脏康复的综合项目的实施受到阻碍。
OHCA 幸存者应常规筛查认知和情绪问题。当轻度认知障碍患者参加心脏康复时，应根据其认知能力调整其康复计划。对于认知或情绪问题严重的患者，个体化康复似乎更有利。建议心脏和认知康复科之间进行综合康复治疗。应关注护理人员的负担。
