Neuroprotection following cardiac arrest
Outcome from cardiac arrest is determined by the severity of any supervening neurological or cardiac dysfunction / instability which results from poor vital organ perfusion. Following return of spontaneous circulation (ROSC), inability of the patient to obey commands indicates that neuroprotection techniques should be considered.
Intravenous fluid bolus: if not contraindicated give 30 ml.kg⁻¹ of cold (4 °C) non glucose-containing solutions.
External: simple ice packs and/or wet towels; cooling blankets or pads; water or air circulating blankets; water circulating gel-coated pads.
Internal: intravascular heat exchanger; cardiopulmonary bypass.
Benzodiazepines or propofol are likely to be closest to hand in the operating theatre.
Sodium valproate, levetiracetam, phenytoin or a barbiturate can also be used.
Cardiac arrest → 2-1