Critical Care after Cardiac Arrest: What You Should Know?
When the heart stops circulating blood in our body, resulting commonly from problems with electrical signals in the heart, it is called a cardiac arrest. The moment the heart stops pumping blood, our brain starts receiving insufficient oxygen supply and stops working efficiently. This results in unconsciousness and unresponsiveness. While resuscitation and calling for medical help are first steps towards helping the patient regain consciousness, there are critical interventions and procedures undertaken in the next couple of hours after the heart attack. Know them:
Hemodynamic Support: Hemodynamic support is provided to maintain the blood pressure in the patient’s body. Hypotension is a condition of low blood pressure that should be treated with the administration of fluids and vasoactive medications to optimize blood pressure. A systolic blood pressure greater than 90 mmHg and a mean arterial pressure greater than 65 mmHg should be maintained during the post-cardiac arrest phase.
Targeted Temperature Management (TTM): TTM, previously known as therapeutic hypothermia, is an intervention that focuses on improved neurological outcomes after cardiac arrest. It is used when the patient fails to understand or follow verbal commands. Induced hypothermia should occur soon after ROSC (return of spontaneous circulation). A common procedure introduced for inducing therapeutic hypothermia is a rapid infusion of ice-cold isotonic, non-glucose-containing fluid which is to maintain an optimum temperature of 32-36 ° C over the next 24 hours. To monitor the temperature, you will need an esophageal thermometer, whose price may vary from a regular thermometer’s price.
Ventilation Management: Post-cardiac arrest patients may also become comatose and require ventilation support. The ventilation setting should be set according to the needs and the condition of the patient. While oxygenation through ventilation support is necessary for the patient to carry out aerobic metabolism, the diabolical effects of hyperoxia are a constant threat. Excess oxygen in our body can have adverse effects on us and can worsen the neurological outcomes. An ECG machine should be used at all times to monitor the heart condition.
Other Considerations: To maintain the glucose level in the body, moderate glycemic measures should be implemented. There is a huge risk of hypoglycemia so proper attention should be given to prevent it. Medical teams focus on providing coronary reperfusion (PCI) and all interventions should be directed towards this goal. PCI has been shown to be safe and effective in both the alert and comatose patient and hypothermia does not contraindicate PCI. Cardiac arrest is becoming more common in today’s times due to unhealthy lifestyles. Even if a person claims to feel fine after an immediate redressal, a thorough inspection by the medical experts is a must. The treatment processes above play crucial roles in effectively bringing the patient on the road to recovery
