The role of cardiovascular professionals in out-of-hospital cardiac arrest (OHCA) care and optimal treatment options are examined in a new viewpoint published in JACC Cardiovascular Interventions.
Karl B. Kern, MD, of the University of Arizona's Sarver Heart Center examines staggering statistics including survival following OHCA, which remains at less than 10 percent of patients surviving. Among those that are resuscitated, only 25 percent make it through the hospitalization that follows and many succumb to the leading causes of death after resuscitation: central nervous system injury and myocardial failure
Citing research done in Norway, Kern emphasizes the importance of aggressive post-cardiac arrest care in the interest of long-term patient survival.
Clinical evidence, Kern writes, shows that resuscitated patients who have undergone cardiac arrest without obvious non-cardiac etiology should "undergo emergency coronary angiography and, where indicated, percutaneous coronary intervention (PCI)." He also notes that for comatose patients, concurrent therapeutic hypothermia is necessary. This treatment approach "can double long-term survival rates" for patients who have been resuscitated following an OHCA.
"Cardiologists, and particularly interventional cardiologists, must assume an increasing role in the care of patients suffering OHCA," writes Kern. "Post-resuscitation care is the key to improving the proportion that not only survive long term, but also survive with favorable neurological function."
It is the duty of the interventional cardiologist to "become a champion" for patients who have been resuscitated. This is to ensure that the patient receives the "best chance for long-term recovery with preserved myocardial and central nervous system function," writes Kern.
Kern concludes that the two most critical aspects of post-resuscitation care are therapeutic hypothermia and early coronary angiography with potential PCI.