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Survivors of out-of-hospital cardiac arrest (OHCA) experience significant mortality rates and neurological impairment, potentially attributed to the hypoxic-ischemic injury sustained amid the cardiac arrest episode. Post-resuscitation care plays a crucial role in determining outcomes for survivors of OHCA. Supportive therapies have proven to be influential in shaping these outcomes. However, targeting higher blood pressure or oxygen levels during the post-resuscitative phase has not been shown to offer any mortality or neurological benefits. In terms of maintaining hemodynamic instability after resuscitation, it is recommended to use norepinephrine rather than epinephrine. While extracorporeal cardiopulmonary resuscitation has shown promising results, targeted temperature management has been found ineffective in improving outcomes despite its previous potential. This review also investigates various challenges and barriers associated with the practical implementation of these supportive therapies in clinical settings. The review also highlights areas ripe for future research and proposes potential directions to further enhance post-resuscitation supportive care for OHCA survivors.
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http://dx.doi.org/10.7759/cureus.44783 | DOI Listing |
Ther Hypothermia Temp Manag
September 2025
University Hospital of Wales, Cardiff, Wales, United Kingdom.
The critical care unit at the University Hospital of Wales is a 38-bedded tertiary center. In 2023, the unit admitted 1251 unscheduled patients, of which 131 were out-of-hospital cardiac arrest (OOHCA) patients. The unit also participated in the Targeted Temperature Management 2 study and adopted the findings shortly after its publication in 2021.
View Article and Find Full Text PDFCardiol Young
September 2025
Department of Anesthesiology and Reanimation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
Objectives: This study aimed to evaluate the predictive accuracy of Paediatric Risk of Mortality-III, Paediatric Index of Mortality-II, and Paediatric Logistic Organ Dysfunction scoring systems for major adverse events following congenital heart surgery.
Methods: This prospective observational study included patients under 18 years of age who were admitted to the ICU for at least 24 hours postoperatively following congenital heart surgery. Major adverse events were defined as a composite of 30-day mortality, ICU readmission, reintubation, acute neurologic events, requirement for extracorporeal membrane oxygenation, cardiac arrest requiring cardiopulmonary resuscitation, need for a permanent pacemaker, acute kidney injury, or unplanned reoperation.
Prog Cardiovasc Dis
September 2025
Department of Cardiology, University of Texas Health Science Center, San Antonio, TX, USA.
Background: Cardiopulmonary resuscitation (CPR) is a vital intervention for managing cardiac arrest; however, enhancing survival rates remains a significant challenge. Recent advancements highlight the importance of integrating artificial intelligence (AI) to overcome existing limitations in prediction, intervention, and post-resuscitation care.
Methods: A thorough review of contemporary literature regarding AI applications in CPR was undertaken, explicitly examining its role in the early prediction of cardiac arrest, optimization of CPR quality, and enhancement of post-arrest outcomes.
Arq Bras Cardiol
September 2025
Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.
Targeted temperature management (TTM) is currently the only potentially neuroprotective intervention recommended for post-cardiac arrest care. However, there are concerns among the scientific community regarding conflicting evidence supporting this recommendation. Moreover, the bulk of trials included in systematic reviews that inform guidelines and recommendations have been conducted in developed countries, with case mix and patient characteristics that significantly differ from the reality of developing countries such as Brazil.
View Article and Find Full Text PDFSci Transl Med
September 2025
Department of Mechanical Engineering, University of California, Santa Barbara, Santa Barbara, CA 93106, USA.
Endotracheal intubation is a critical medical procedure for protecting a patient's airway. Current intubation technology requires extensive anatomical knowledge, training, technical skill, and a clear view of the glottic opening. However, all of these may be limited during emergency care for trauma and cardiac arrest outside the hospital, where first-pass failure is nearly 35%.
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