Page 77 - Proceeding of Plenary Abstract of Parallel Symposim

Post Resuscitation Care: What Should We Do?

Indra Saputra
Department of Child Health, Faculty of Medicine, Universitas Sriwijaya/Dr. Mohammad Hoesin General Hospital, Palembang, South Sumatera, Indonesia

Abstract
Background Pediatric cardiac arrest etiology is different from the adult. Return of spontaneous circulation
(ROSC) that develops after cardiac arrest or resuscitation from severe shock or respiratory failure should be
followed by a systematic approach to assess and support the respiratory, cardiovascular, and neurologic systems.
Objective To describe the management of patient after having cardiac arrest or resuscitation. Methods This
review was searched all known literature in the references to relevant study. Results Successful resuscitation
from cardiac arrest results in a post-cardiac arrest syndrome, which can evolve in the days to weeks after the
return of sustained circulation. The components of post-cardiac arrest syndrome are brain injury, myocardial
dysfunction, systemic ischemia/ reperfusion response, and persistent precipitating pathophysiology. Pediatric
post-cardiac arrest care focuses on anticipating, identifying, and treating this complex physiology to improve
survival and neurological outcomes. A post-arrest reevaluation includes assessing the adequacy of pulses,
perfusion, blood pressure, and adequacy of oxygenation and ventilation. Post-arrest monitoring includes
continuous cardiac monitoring, end-tidal carbon dioxide (CO2) measurements, possible brain monitoring,
and trending lab work. Hemodynamic instability and respiratory complication usually cause early mortality.
Multiorgan failure or brain injury or both of them can create late morbidity and mortality. The outcome
is often determined by the subsequent care the child receives. This includes safe transport to a center with
expertise in caring for seriously ill or injured children. Conclusion Post resuscitation care should be managed
to improve the outcome of children after having successful resuscitation from cardiac arrest.
Keywords: pediatric; post cardiac arrest care; resuscitation; outcome

62 Abstract