tailieunhanh - Ebook Cardiac arrest - The science and practice of resuscitation medicine (2nd edition): Part 2

(BQ) Part 2 book "Cardiac arrest - The science and practice of resuscitation medicine" presents the following contents: Postresuscitation disease and its care, special resuscitation circumstances, special resuscitation circumstances, special issues in resuscitation. | Part V Postresuscitation disease and its care 47 Postresuscitation syndrome Erga L. Cerchiari Department of Anaesthesia and Critical Care Ospedale Maggiore and Area of Anaesthesia and Critical Care Surgical Department Provincial Health Care Structure Bologna Italy The postresuscitation syndrome PRS has been defined as a condition of an organism resuscitated following prolonged cardiac arrest caused by a combination of whole body ischemia and reperfusion and characterized by multiple organ dysfunction including neurologic Background Following resuscitation from cardiac arrest patients either recover consciousness or remain unconscious depending on the duration of cardiac arrest and the effectiveness of any CPR but also on prearrest conditions such as age and Shortening no-flow times by timely interventions that can maintain some perfusion and promote the restoration of spontaneous circulation . bystander CPR early defibrillation and other means improves the possibility of a successful outcome with the patient recovering The wider availability of resuscitation techniques to reverse clinical death however has led to increasingly frequent observations of a pathological condition occurring in patients who remain unconscious involving multiple organ injury or failure following reperfusion after prolonged cardiac arrest. The concept of postresuscitation disease as a unique and new nosological entity was introduced by Negovsky in 1972 4 5 the most interesting aspect of this innov ative concept was the recognition that the etiology depended on a combination of severe circulatory hypoxia with the unintended sequelae of measures used for resuscitation. On the basis of the wide variety of ischemic hypoxic mechanisms that can trigger its development the disease was redefined by Safar as a syndrome in which pathogenetic processes triggered by cardiac arrest were exacerbated by reperfusion causing damage to the brain and other .