Podcast: Play in new window | Download

Subscribe: Apple Podcasts | Google Podcasts | Stitcher | RSS

How do we improve neurologic recovery after cardiac arrest? Part of the problem that we have as resuscitationists (and that’s what we are) is that after we achieve ROSC with a patient, they end up brain dead shortly after our encounter. So what can we do to fix it? These questions don’t have any easy answers. The more research that is done, the more questions we have. More questions tend to lead to less answers. What about targeted temperature management? Remember when that was all the rage? After a couple of years of research, it turns out that it doesn’t work terribly well.

We’ve already discussed on this podcast that we have no idea what we’re doing in cardiac arrest, but what can we do to fix it? Part of the underlying problem is that there are no national or international standards for cardiac arrest. What’s good for St. Louis isn’t necessarily good for St. Petersburg.

Beyond that, we have to ask ourselves if we’re working our cardiac arrests long enough. We know that patient in VF arrest are likely to achieve ROSC, and that those in asystole are unlikely to achieve ROSC. But how long should we work these patients? There is reasonable data now showing that VF arrests may have decent neurologic function after an hour. We can do better.

Source article: Maciel, et al. 2017.