title: Emergency Neurological Life Support: Resuscitation Following Cardiac Arrest.
abstract: Cardiac arrest is the most common cause of death in North America. Neurocritical care interventions, including targeted temperature management (TTM), have significantly improved neurological outcomes in patients successfully resuscitated from cardiac arrest. Therefore, resuscitation following cardiac arrest was chosen as an emergency neurological life support protocol. Patients remaining comatose following resuscitation from cardiac arrest should be considered for TTM. This protocol will review induction, maintenance, and re-warming phases of TTM, along with management of TTM side effects. Aggressive shivering suppression is necessary with this treatment to ensure the maintenance of a target temperature. Ancillary testing, including electrocardiography, computed tomography and/or magnetic resonance imaging of the brain, continuous electroencephalography monitoring, and correction of electrolyte, blood gas, and hematocrit changes, are also necessary to optimize outcomes.
authors.affiliation: Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, USA. rittenbergerjc@upmc.edu.
authors.forename: Jon C
authors.initials: JC
authors.lastname: Rittenberger
authors.affiliation: Department of Pediatrics, Washington University School of Medicine, St. Louis, St. Louis, MO, USA.
authors.forename: Stuart
authors.initials: S
authors.lastname: Friess
authors.affiliation: Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Kees H
authors.initials: KH
authors.lastname: Polderman
mesh_terms: D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D008020:Life Support Care / Q000379:methods*; D009462:Neurology / Q000379:methods*; D012151:Resuscitation / Q000379:methods*
keywords: Brain cooling; Cardiac arrest; Hypothermia; Myocardial infarction; Sudden death; Temperature management