Category: Critical Care
Posted: 9/8/2014 by John Greenwood, MD
(Updated: 9/9/2014)
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Goal-Directed Resuscitation During Cardiac Arrest
Focusing on high-quality CPR is by far one of the most effective methods to ensure your arrested patient has the best chance to survive. However, emerging evidence suggests that there are additional goals that we should try and accomplish during our resuscitation.
As we continue to move toward goal-directed resuscitation strategies, optimizing coronary perfusion pressure (CPP) may be our next target in “personalizing” the care we provide to those in cardiac arrest.
A recent AHA consensus statement recommended the following physiologic goals during cardiac arrest care:
Each of these variables can give the provider valuable feedback about how their patient is responding to their resuscitation. Some argue that the DBP target should be much higher (>35 mmHg), with the caveat that pharmacologic optimization can only occur once high quality CPR is confirmed. The goal should always be to minimize the use of epinephrine whenever possible!
Bottom Line: During your next cardiac arrest resus, consider using a goal-directed strategy by monitoring the patient’s CPP, DBP, & EtCO2 to determine the effectiveness of your resuscitation.
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