Premium
Emergent percutaneous coronary intervention for resuscitated victims of out‐of‐hospital cardiac arrest
Author(s) -
Kern Karl B.,
Rahman Ossama
Publication year - 2010
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.22192
Subject(s) - medicine , conventional pci , hypothermia , percutaneous coronary intervention , cardiopulmonary resuscitation , resuscitation , cardiology , intensive care medicine , anesthesia , myocardial infarction
Long‐term survival rates even after successful resuscitation from out‐of‐hospital cardiac arrest are dismal. Most of those initially resuscitated expired during their hospitalization. Recent reports have suggested that a more aggressive approach to postresuscitation care is the key to better outcome. Waiting for the evidence of neurological recovery before acting can result in missed opportunity to improve such recovery. Immediate induction of mild therapeutic hypothermia for all resuscitated victims who remain comatose offers the best hope for neurological recovery. Numerous reports suggest that early coronary angiography and PCI also improve outcome among those resuscitated from cardiac arrest whose postresuscitation ECG show evidence of ST elevation myocardial infarctions. Most promising is combining these two postresuscitation therapies, namely immediate induction of hypothermia and early coronary angiography and PCI. Combining these therapies has resulted in long‐term survival rates of 70% with more than 80% of all such survivors neurologically functional. Even those without ST elevation on their postresuscitation ECG can greatly benefit from timely induction of hypothermia and early angiography/PCI. © 2009 Wiley‐Liss, Inc.