Critical Post-Arrest Interventions

• Critical interventions to optimize neurologic outcome in the post-cardiac arrest patient include optimizing hemodynamics, preventing lung injury, maintaining normal O2 and CO2 tensions, targeted temperature management, and treating the underlying cause of the arrest.
• Current guidelines recommend the following:
  • Target MAP > 70 mm Hg with IVFs, vasopressors, and inotropes.
  • Use a low tidal volume strategy of 6 to 8 ml/kg predicted body weight.
  • Decrease FiO2 to maintain SpO2 94% to 97%.
  • Adjust RR to maintain PaCO2 35 to 45 mm Hg
  • Initiate TTM with the goal temperature between 32 to 36^o C

References

Walker AC, Johnson NJ. Critical care of the post-cardiac arrest patient. Cardiol Clin. 2018; 36:419-428.