title: [Pathophysiology and management of post-cardiac arrest syndrome].
abstract: OBJECTIVE
  This review aims at providing an update on post-cardiac arrest syndrome, from pathophysiology to treatment.
  
  
  METHODS
  Medline database.
  
  
  METHODS
  All data on pathophysiology, clinical manifestations and therapeutic management, with focus on the publications of the 5 last years.
  
  
  RESULTS
  Care of the patients after cardiac arrest is a medical challenge, in face of "post-cardiac arrest syndrome", which culminates into multi-organ failure. This syndrome mimics sepsis-related dysfunctions, with all clinical and biological manifestations related to the phenomenon of global ischemia-reperfusion. Acute cardiocirculatory dysfunction is usually controlled through pharmacological and mechanical support. Meanwhile, as a majority of cardiac arrest is related to myocardial infarction, early angiographic exploration should then be discussed when there is no obvious extracardiac cause, percutaneous coronary revascularization being associated with improved short and long-term prognosis. Therapeutic hypothermia is the cornerstone of neuroprotective armamentarium, beyond hemodynamic stabilization and metabolic maintenance.
  
  
  CONCLUSIONS
  If ongoing evaluations should shed light on potential efficiency of new therapeutic drugs, a multidisciplinary approach of the post-cardiac arrest syndrome in expertise centre is essential.
authors.affiliation: Service de réanimation médicale, Assistance publique-Hôpitaux de Paris, groupe hospitalier Cochin Broca Hôtel-Dieu, CHU Cochin, 75014 Paris, France; Unité de réanimation de chirurgie cardiovasculaire, service d'anesthésie et des réanimations chirurgicales, Assistance publique-Hôpitaux de Paris, groupe hospitalier Henri-Mondor-Albert-Chenevier, CHU Henri-Mondor, 94000 Créteil, France; Faculté de médecine, université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France; Faculté de médecine, université Paris Est, 94000 Créteil, France; Inserm U955, équipe 3 « physiopathologie et pharmacologie des insuffisances coronaires et cardiaques », 94000 Créteil, France; Université Paris Est, école nationale vétérinaire d'Alfort, 94700 Maisons-Alfort, France. Electronic address: nicolas.mongardon@hmn.aphp.fr.
authors.forename: N
authors.initials: N
authors.lastname: Mongardon
authors.forename: A
authors.initials: A
authors.lastname: Bouglé
authors.forename: G
authors.initials: G
authors.lastname: Geri
authors.forename: F
authors.initials: F
authors.lastname: Daviaud
authors.forename: T
authors.initials: T
authors.lastname: Morichau-Beauchant
authors.forename: R
authors.initials: R
authors.lastname: Tissier
authors.forename: F
authors.initials: F
authors.lastname: Dumas
authors.forename: A
authors.initials: A
authors.lastname: Cariou
mesh_terms: D003428:Cross Infection / Q000517:prevention & control; D006323:Heart Arrest / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced; D009102:Multiple Organ Failure / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D009422:Nervous System Diseases / Q000209:etiology / Q000628:therapy; D018696:Neuroprotective Agents / Q000627:therapeutic use; D012769:Shock / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D013577:Syndrome
chemical_list: D018696:Neuroprotective Agents
keywords: Arrêt cardiaque; Cardiac arrest; Choc; Coronarographie; Coronary angiogram; Hypothermie thérapeutique; Outcome; Pronostic; Shock; Therapeutic hypothermia