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Hypoxemia Tamponade
(pericardial)
Hypovolemia
Tension pneumo thorax
Hypo/Hyperthermia
Toxins/poisons/drugs
Hypo/Hyperkalemia
Thrombosis (PE,MI)
Metabolic derangements
Neurologic damage is caused by both Ischemic event
and Reperfusion that follows later on …
Increased free radicals.
Release of cytotoxins.
Problem we face after ROSC
POST – RESUCITATION
CEREBRAL SYNDROME
Post-resuscitation cerebral syndrome
Cardiovascular
Pulmonary
Water & electrolytes
Haematological
Metabolic
Therapeutic Hypothermia
Cardiovascular measures
Maintaining systemic perfusion pressure with vaso active
drugs + Fluid resuscitation
Hypothermic gp Normothermic gp
136 cases 137 cases
Favourable
neurologic 55% 39%
Outcome
Mortality
at 6 months 41% 55%
Results: Australian study
Hypothermic gp Normothermic gp
43 cases 34 cases
Favourable
neurologic 49% 26%
Outcome
Mortality
at 6 months 51% 68%
International Liaison Committee On
Resucitation (ILCOR)
Recommendation – October 2002
Unconscious adult patients with spontaneous
Infection (pneumonia)
Coagulopathy
blockers,sedatives.
N-Methyl-D-aspartate scavengers.
hydroperoxide scavengers.
? ATP substitutes
?Immunotherapy
?Leukopheresis detoxification