Salwa Kamil, Kaziród-Wolski Karol, Rębak Dorota, Sielski Janusz
Intensive Cardiac Care Unit, Świetokrzyskie Cardiology Center, 25-736 Kielce, Poland.
Institute of Medical Sciences, Collegium Medicum, Jan Kochanowski University in Kielce, 25-317 Kielce, Poland.
Healthcare (Basel). 2025 Jul 30;13(15):1865. doi: 10.3390/healthcare13151865.
Sudden cardiac arrest (SCA) is a major global health concern with high mortality despite advances in resuscitation techniques. Achieving return of spontaneous circulation (ROSC) represents merely the initial step in the extensive rehabilitation journey. This review highlights the critical role of structured, multidisciplinary rehabilitation following ROSC, emphasizing the necessity of integrated physiotherapy, neurocognitive therapy, and psychosocial support to enhance quality of life and societal reintegration in survivors. This narrative review analyzed peer-reviewed literature from 2020-2025, sourced from databases such as PubMed, Scopus, Web of Science, and Google Scholar. Emphasis was on clinical trials, expert guidelines (e.g., European Resuscitation Council 2021, American Heart Association 2020), and high-impact journals, with systematic thematic analysis across rehabilitation phases. The review confirms rehabilitation as essential in addressing Intensive Care Unit-acquired weakness, cognitive impairment, and post-intensive care syndrome. Early rehabilitation (0-7 days post-ROSC), focusing on parameter-guided mobilization and cognitive stimulation, significantly improves functional outcomes. Structured interdisciplinary interventions encompassing cardiopulmonary, neuromuscular, and cognitive domains effectively mitigate long-term disability, facilitating return to daily activities and employment. However, access disparities and insufficient randomized controlled trials limit evidence-based standardization. Optimal recovery after SCA necessitates early and continuous interdisciplinary engagement, tailored to individual physiological and cognitive profiles. Persistent cognitive fatigue, executive dysfunction, and emotional instability remain significant barriers, underscoring the need for holistic and sustained rehabilitative approaches. Comprehensive, individualized rehabilitation following cardiac arrest is not supplementary but fundamental to meaningful recovery. Emphasizing early mobilization, neurocognitive therapy, family involvement, and structured social reintegration pathways is crucial. Addressing healthcare disparities and investing in rigorous randomized trials are imperative to achieving standardized, equitable, and outcome-oriented rehabilitation services globally.
心脏骤停（SCA）是一个重大的全球健康问题，尽管复苏技术有所进步，但死亡率仍然很高。实现自主循环恢复（ROSC）仅仅是漫长康复过程的第一步。本综述强调了ROSC后结构化、多学科康复的关键作用，强调了综合物理治疗、神经认知治疗和心理社会支持对于提高幸存者生活质量和重新融入社会的必要性。 本叙述性综述分析了2020年至2025年的同行评审文献，这些文献来自PubMed、Scopus、科学网和谷歌学术等数据库。重点是临床试验、专家指南（如欧洲复苏委员会2021年、美国心脏协会2020年）以及高影响力期刊，并对康复阶段进行了系统的主题分析。 该综述证实康复对于解决重症监护病房获得性肌无力、认知障碍和重症监护后综合征至关重要。早期康复（ROSC后0至7天），侧重于参数引导的活动和认知刺激，可显著改善功能结局。涵盖心肺、神经肌肉和认知领域的结构化跨学科干预措施可有效减轻长期残疾，促进恢复日常活动和就业。然而，获取方面的差异和随机对照试验不足限制了基于证据的标准化。 SCA后的最佳恢复需要早期和持续的跨学科参与，根据个体的生理和认知特征进行调整。持续的认知疲劳、执行功能障碍和情绪不稳定仍然是重大障碍，这突出了全面和持续康复方法的必要性。 心脏骤停后的全面、个性化康复不是补充，而是有意义恢复的基础。强调早期活动、神经认知治疗、家庭参与和结构化的社会重新融入途径至关重要。解决医疗保健差距并投资于严格的随机试验对于在全球范围内实现标准化、公平和以结果为导向的康复服务至关重要。
