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Abstract Introduction: Outcomes from cardiac arrest have improved over the last decade, due to an increased focus on early recognition of the arrest and high quality cardiopulmonary resuscitation. After return of spontanous circulation, persistent pathophysiologic alterations, which have been identified as the ‘post cardiac arrest syndrome’, can contribute to poor outcomes. Post cardiac arrest syndrome has four major components: brain injury, myocardial dysfunction, systemic ischemia/reperfusion response and persistent precipitating disease. Recognition and treatment of these key components may decrease the risk of ongoing secondary injuries and can thereby improve survival. Objectives: This review aims to discuss the pathophysiology and management of post cardiac arrest syndrome in adults and pediatrics in intensive care unit. Data Source: Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2017. Study selection: This search presented 151 articles. The articles studied the post cardiac arrest syndrome in adults and pediatrics to purify the most recent studies in this field. Data Extraction: If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures. Data Synthesis: Comparisons were made by structured review with the results tabulated. Conclusion: There is growing recognition that integrated post resuscitation care which encompasses targeted temperature management, early coronary angiography and comprehensive critical care can improve patient outcomes. Targeted temperature management can improve survival and neurological outcome in patients who remain comatose especially following out-of-hospital cardiac arrest. Early coronary angiography and revascularization if needed may also be beneficial during the post resuscitation phase. In addition, resuscitated patients usually require intensive care, which includes mechanical ventilator, hemodynamic support and close monitoring of blood gases, glucose, electrolytes, seizures and other disease specific intervention. |