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Postcardiac Arrest Syndrome: Controlled Reoxygenation
- In previous pearls, Dr. Marcolini has highlighted the poscardiac arrest syndrome (PCAS), comprised of brain injury, myocardial dysfunction, systemic ischemia/reperfusion response, and persistent precipitating disease.
- Not surprisingly, postcardiac arrest brain injury is a major cause of morbidity and mortality, accounting for > 60% of deaths in some studies.
- In addition to therapeutic hypothermia, consider "controlled reoxygenation" in order to optimize neurologic outcome.
- Animal data has demonstrated that too much oxygen may worsen neuronal damage during the initial resuscitation phase.
- Take Home Points:
- Use a minimum amount of FiO2 to maintain SpO2 of 94-96%
- Avoid unnecessary arterial hyperoxia
References
Nolan JP, Soar J. Postresuscitation care: entering a new era. Curr Opin Crit Care 2010;16:216-22.