Page 26 - ARRS - Excellent in Science 2015

26 MEDICAL SCIENCES / Cardiovascular system Back to Index

sudden out-of-hospital

cardiac arrest and modern

postresuscitation management

Sudden cardiac arrest remains of cardiac arrest. We were first to
the leading cause of death in de- demonstrate that combining ur-
veloped countries with anual inci- gent invasive coronary strategy
dence ranging from 36 to 81 events with hypothermia is feasible and
per 100.000 inhabitants. Following safe. importantly, survival with
initial cardiocerebral resuscitation good neurological recovery con-
on the field, reestablishment of comitantly increased from 27% be-
spontaneous circulation (RoSc) is tween 1995-2003 to 47% between
achieved in 40 to 60% of patients 2004-2012.
who are subsequently transported
to emergency department. Be-
cause of typical delays in “chain
of survival”, up to 80% of patients
remain comatose despite RoSc
which pinpoints to postresuscita-
tion brain injury. We started to use

mild induced hypothermia (32 and
of 34 c for 24 hours) to decrease
the likelihood of unfavorable neu-
rological outcome for the first time
in September 2003 and since then
it soon became a standard of care.
Since we are primary Pci center for
ST-elevation myocardial infarction
(STeMi) with 24-hour service since the blockage of coronary artery
year 2000, we gradually adopted a
strategy of urgent coronary angi-
ography and Pci also in survivors
Source 1: BNOÄŚ, Marko, FAJADET, J., LASSEN, JF, KALA, P, MACCARTHY, P, OLIVECRONA, GK,
WINDECKER, S, SPAULDING, C. Invasive coronary treatment strategies for out-of-hospital
cardiac arrest: a consensus statement from the European association for percutaneous
cardiovascular interventions (EAPCI)/stent for life (SFL) groups. EuroIntervention, ISSN 1774-
024X, 2014, vol. 10, no. 1, str. 31-37.
Source 2: TADEL, Ĺ pela, JAZBEC, Anja, NOÄŚ, Marko. Impact of intensified postresuscitation
treatment on outcome of comatose survivors of out-of-hospital cardiac arrest according to
initial rhythm. Resuscitation, ISSN 0300-9572. [Print ed.], 2014, vol. 85, iss. 10, str. 1364-1369.