SCCM Resource Library-The Last Mile: Post-Cardiac Arrest Care

Video Transcription

Video Summary

The post-cardiac arrest care algorithm focuses on respiratory optimization, hemodynamic optimization, and neuroprotection. In terms of respiratory optimization, the algorithm recommends evaluating the patient's respiratory status and determining whether they are breathing spontaneously. If not, providing positive pressure ventilation and monitoring end-tidal CO2 levels to ensure it is in the reference range. If the patient is hyperventilating or hypoventilating, the underlying cause should be addressed and corrected. In terms of hemodynamic optimization, the algorithm recommends evaluating the patient's blood pressure and assessing whether it is hypotensive, normotensive, or hypertensive. Depending on the blood pressure reading, interventions such as fluid boluses or pressors may be needed to address hypotension. If the patient is normotensive, the algorithm suggests assessing whether there is adequate oxygen delivery to the tissues and addressing any deficits if necessary. The neuroprotection part of the algorithm focuses on hypothermia, osmotic agents for cerebral edema, and seizure treatment. The use of hypothermia to protect the brain is still being studied and its benefits are not yet conclusive. Osmotic agents such as mannitol or hypertonic saline may be used to treat cerebral edema, especially in patients who are comatose or apneic. Overall, the algorithm provides a systematic approach to post-cardiac arrest care with a focus on optimizing respiratory function, maintaining hemodynamic stability, and protecting the brain. However, further research is needed to evaluate the effectiveness of these interventions and to refine the algorithm.

Asset Subtitle

Professional Development and Education, Cardiovascular, 2020

Asset Caption

This is a presentation from the 2020 Critical Care Congress precourse, Cardiopulmonary Resuscitation, Electrolyte, and Acid-Base Disorders for the Veterinary Emergency and Critical Care Specialist. The Last Mile: Post-Cardiac Arrest Care was presented by Daniel Fletcher, PhD, DVM, DACVECC.

The course covered topics including updates from research, electrolyte disorders commonly and less commonly seen in the critical care setting, importance of chloride and its role in resuscitation management and the kidney, and acid-base disorders, including physiology, blood gas interpretation, and treatment.

Meta Tag

Content Type Presentation

Knowledge Area Professional Development and Education

Knowledge Area Cardiovascular

Knowledge Level Advanced

Membership Level Select

Membership Level Professional

Membership Level Associate

Tag Veterinary Medicine

Tag Cardiac Arrest

Tag Cardiothoracic Critical Care

Year 2020

Keywords

respiratory optimization

hemodynamic optimization

neuroprotection

positive pressure ventilation

hypotension

normotension

hypertension

cerebral edema

algorithm refinement

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