When ?• 2 hours • Bernard SA, Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med. 2002;346:557–563.• 8 hours • Neumar RW, et al. Circulation. 2008;118: 2452– 2483.
Supportive care• Sedation: – Opioids, anxiolytics, and sedative-hypnotic • Various combinations – Muscel relaxants • Only in life threatening agitation • Along with sedation – Less duration – Frequent NM Monitoring
Supportive care• Seizure control – EEG as soon as possible – All comatose patients – Myoclonus: – Clonazepam – General Seizures – Benzodiazepines – Barbiturates – Phenytoin – Propofol
Supportive care• Dysrhythmias: – Standard medical therapies – No prophylaxis required• Steroids: – relative adrenal insufficiency in the post– cardiac arrest phase • Associated with higher rates of mortality – Routine use : Uncertain
References• 1. Part 9: Post–Cardiac Arrest Care: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care – Circulation. 2010;122:S768-S786,• 2.UptoDate 2012