title: Usefulness of cardiac arrest centers - extending lifesaving post-resuscitation therapies: the Arizona experience - .
abstract: The post-cardiac arrest syndrome is a complex, multisystems response to the global ischemia and reperfusion injury that occurs with the onset of cardiac arrest, its treatment (cardiopulmonary resuscitation) and the re-establishment of spontaneous circulation. Regionalization of post-cardiac arrest care, utilizing specified cardiac arrest centers (CACs), has been proposed as the best solution to providing optimal care for those successfully resuscitated after out-of-hospital cardiac arrest. A multidisciplinary team of intensive care specialists, including critical care/pulmonologists, cardiologists (general, interventional, and electrophysiology), neurologists, and physical medicine/rehabilitation experts, is crucial for such centers. Particular attention to the timely initiation of targeted temperature management and early coronary angiography/percutaneous coronary intervention is best provided by such CACs. A State-wide program of CACs was started in Arizona in 2007. This is a voluntary program, whereby medical centers agree to provide all resuscitated cardiac arrest patients brought to their facility with state-of-the-art post-resuscitation care, including targeted temperature management for comatose patients and strong consideration for emergent coronary angiography for all patients with a likely cardiac etiology for their cardiac arrest. Survival improved by more than 50% at facilities that became CACs with a commitment to provide aggressive post-resuscitation care to all such patients. Providing aggressive, post-resuscitation care is the next real opportunity to increase long-term survival for cardiac arrest patients.
authors: Sarver Heart Center, University of Arizona.
authors: Karl B
authors: KB
authors: Kern
mesh_terms: D000328:Adult; D001130:Arizona; D016887:Cardiopulmonary Resuscitation / Q000193:education / Q000379:methods; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy; D006785:Hospitals, University / Q000458:organization & administration; D006801:Humans; D007022:Hypotension / Q000209:etiology / Q000628:therapy; D015428:Myocardial Reperfusion Injury / Q000209:etiology / Q000628:therapy*; D017682:Myocardial Stunning / Q000188:drug therapy / Q000209:etiology; D058687:Out-of-Hospital Cardiac Arrest / Q000150:complications / Q000401:mortality / Q000628:therapy*; D010348:Patient Care Team; D012770:Shock, Cardiogenic / Q000209:etiology / Q000628:therapy; D014187:Transportation of Patients