Post-cardiac arrest syndrome

Post-cardiac arrest syndrome
Other namesPost-resuscitation disease
SymptomsBrain injury, myocardial injury, systemic ischemia/reperfusion response
Usual onsetAfter resuscitation from a cardiac arrest
DurationWeeks
CausesGlobal ischemia-reperfusion injury
Risk factorsProlonged cardiac arrest
Differential diagnosisSystemic inflammatory response syndrome
ManagementHemodynamic stabilization and supportive care

Post-cardiac arrest syndrome (PCAS) is an inflammatory state of pathophysiology that can occur after a patient is resuscitated from a cardiac arrest.[1] While in a state of cardiac arrest, the body experiences a unique state of global ischemia. This ischemia results in the accumulation of metabolic waste which instigate the production of inflammatory mediators. If return of spontaneous circulation (ROSC) is achieved after CPR, then circulation resumes, resulting in global reperfusion and the subsequent distribution of the ischemia products throughout the body. While PCAS has a unique cause and consequences, it can ultimately be thought of as type of global ischemia-reperfusion injury.[2] The damage, and therefore prognosis, of PCAS generally depends on the length of the patient's ischemic period; therefore the severity of PCAS is not uniform across different patients.

  1. ^ Abella, Benjamin S.; Bobrow, Bentley J. (2020), Tintinalli, Judith E.; Ma, O. John; Yealy, Donald M.; Meckler, Garth D. (eds.), "Post–Cardiac Arrest Syndrome", Tintinalli's Emergency Medicine: A Comprehensive Study Guide (9 ed.), New York, NY: McGraw-Hill Education, retrieved 2022-01-19
  2. ^ Kang, Youngjoon (August 2019). "Management of post-cardiac arrest syndrome". Acute and Critical Care. 34 (3): 173–178. doi:10.4266/acc.2019.00654. PMC 6849015. PMID 31723926.