© The Board of Management and Trustees of the British Journal of Anaesthesia 2008. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Post-cardiac arrest management: more than global cooling?
| The first 150 words of the full text of this article appear below. |
Approximately 150 000 sudden cardiac deaths occur per year in the UK.1 For those who survive a cardiac arrest, it is estimated that as few as 10% will make a full recovery because of global hypoxic brain injury.2 Cardiopulmonary resuscitation guidelines3 and practitioners involved in emergency resuscitation have naturally focused on strategies to restore an effective cardiac rhythm, including early defibrillation, cardiac massage, and drug therapy. However, outcome in patients resuscitated to achieve a spontaneous circulation remains poor. Overall survival to discharge after out-of-hospital cardiac arrest is approximately 5%, and of those admitted to ICU approximately 25–40% will survive to discharge with conventional therapy.4 Less than 10% of survivors can regain their former lifestyle, largely because of disability caused by hypoxic brain damage. Many require constant care; some remain unable to return to gainful activity because of severe memory problems or cognitive disturbance.5 The human and economic costs of hypoxic
Therapeutic hypothermia
Pathophysiology of neuronal damage
Effects of hypothermia
Practical aspects
Other target therapies
Conclusions
1 Department of Anaesthesia, Critical Care and Pain Management
University Hospitals of Leicester NHS Trust
Leicester Royal Infirmary
Infirmary Square
Leicester LE1 5WW
UK
2 Department of Neurology
University Hospitals of Leicester NHS Trust
Leicester General Hospital
Gwendolen Road
Leicester LE5 4PW
UK
* E-mail: jt23@leicester.ac.uk