title: Canadian Cardiovascular Society/Canadian Cardiovascular Critical Care Society/Canadian Association of Interventional Cardiology Position Statement on the Optimal Care of the Postarrest Patient.
abstract: Out of hospital cardiac arrest (OHCA) is associated with a low rate of survival to hospital discharge and high rates of neurological morbidity among survivors. Programmatic efforts to institute and integrate OHCA best care practices from the bystander response through to the in-hospital phase have been associated with improved patient outcomes. This Canadian Cardiovascular Society position statement was developed to provide comprehensive yet practical recommendations to guide the in-hospital care of OHCA patients. Using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system recommendations have been generated. Recommendations on initial care delivery on the basis of presenting rhythm, appropriate use of targeted temperature management, postarrest angiography, and revascularization in the initial phase of care of the OHCA patient are detailed within this statement. In addition, further description of best practices on sedation, use of neuromuscular blockade, oxygenation targets, hemodynamic monitoring, and blood product transfusion triggers in the critical care environment are contained in this document. Last, discussion of optimal care systems for the OHCA patient is provided. These guidelines aim to serve as a practical guide to optimize the in-hospital care of survivors of cardiac arrest and encourage the adoption of "best practice" protocols and treatment pathways. Emphasis is placed on integrating these aspects of in-hospital care as part of a postarrest "care bundle." It is hoped that this position statement can assist all medical professionals who treat survivors of cardiac arrest.
authors.affiliation: Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: gcwong@mail.ubc.ca.
authors.forename: Graham C
authors.initials: GC
authors.lastname: Wong
authors.affiliation: Mazankowski Heart Institute, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Sean
authors.initials: S
authors.lastname: van Diepen
authors.affiliation: Hamilton General Hospital, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Craig
authors.initials: C
authors.lastname: Ainsworth
authors.affiliation: St Boniface General Hospital, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Rakesh C
authors.initials: RC
authors.lastname: Arora
authors.affiliation: Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, Quebec, Canada.
authors.forename: Jean G
authors.initials: JG
authors.lastname: Diodati
authors.affiliation: Montreal Heart Institute, Université de Montréal, Montréal, Quebec, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Liszkowski
authors.affiliation: Queen Elizabeth II Health Sciences Center, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Love
authors.affiliation: University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Chris
authors.initials: C
authors.lastname: Overgaard
authors.affiliation: Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Greg
authors.initials: G
authors.lastname: Schnell
authors.affiliation: Montreal Heart Institute, Université de Montréal, Montréal, Quebec, Canada.
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Tanguay
authors.affiliation: University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: George
authors.initials: G
authors.lastname: Wells
authors.affiliation: Ottawa Heart Institute, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Michel
authors.initials: M
authors.lastname: Le May
mesh_terms: D002170:Canada; D002309:Cardiology; D016887:Cardiopulmonary Resuscitation / Q000592:standards*; D003422:Critical Care / Q000592:standards*; D004632:Emergency Medical Services; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D017410:Practice Guidelines as Topic; D012955:Societies, Medical