title: Haemodynamic and ventilator management in patients following cardiac arrest.
abstract: OBJECTIVE
  The purpose of this study is to review the recent literature describing how to assess and treat postcardiac arrest syndrome associated haemodynamics and manage oxygenation and ventilation derangements.
  
  
  RESULTS
  Postcardiac arrest syndrome is a well described entity that includes systemic ischemia-reperfusion response, myocardial dysfunction and neurologic dysfunction. Continued resuscitation in the hours to days following return of spontaneous circulation (ROSC) is important to increase the likelihood of long-term survival and neurological recovery. Post-ROSC hypotension is common and associated with worse outcome. Myocardial dysfunction peaks in the first 24  h following ROSC and in survivors resolves over the next few days. Hyperoxemia (paO₂>300  mmHg) and hypoxemia (paO₂<60  mmHg) are associated with worse outcomes and hyperventilation may exacerbate cerebral ischemic injury by decreasing cerebral oxygenation.
  
  
  CONCLUSIONS
  Patients who are successfully resuscitated from cardiac arrest often have hypotension and myocardial dysfunction. Careful attention to haemodynamic and ventilator management targeting normal blood pressure, normoxemia and normocapnia may help to avoid secondary organ injury and potentially improve outcomes.
authors.affiliation: aDepartment of Anesthesia and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia bDepartment of Anesthesia and Critical Care Medicine, The University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA cDepartment of Intensive Care, Hopital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Alexis A
authors.initials: AA
authors.lastname: Topjian
authors.forename: Robert A
authors.initials: RA
authors.lastname: Berg
authors.forename: Fabio Silvio
authors.initials: FS
authors.lastname: Taccone
mesh_terms: D000293:Adolescent; D000368:Aged; D001784:Blood Gas Analysis; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects*; D002648:Child; D005260:Female; D006321:Heart / Q000503:physiopathology; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006439:Hemodynamics; D006801:Humans; D007022:Hypotension / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015428:Myocardial Reperfusion Injury / Q000628:therapy; D012121:Respiration, Artificial