More than 250 000 cardiac surgical procedures are performed annually in the United States. Postoperative cardiac arrest rates range from 0.7% to 5.2%. This article reviews current evidence for cardiac arrest resuscitation after cardiac surgery. The evaluation included resuscitation guidelines and 22 studies identified through a MEDLINE search. Evidence-based resuscitation differs from advanced cardiovascular life support guidelines. European Resuscitation Council guidelines include correcting reversible causes of arrest, applying defibrillation/pacing before external cardiopulmonary resuscitation, resternotomy within 5 minutes if electrical therapies fail, and restricting epinephrine use to avoid rebound hypertension. A 2017 Society of Thoracic Surgeons protocol derived from European Resuscitation Council guidelines is now standard of care in the United States. Evidence-based practices can improve survival and reduce resternotomy rates. This article describes the clinical implementation of the Society of Thoracic Surgeons guidelines.
Cover| February 01 2019
Cardiac Arrest After Cardiac Surgery: An Evidence-Based Resuscitation Protocol
Patrick Michaelis, BSN, RN;
Crit Care Nurse (2019) 39 (1): 15-25.
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Patrick Michaelis, Richard J. Leone; Cardiac Arrest After Cardiac Surgery: An Evidence-Based Resuscitation Protocol. Crit Care Nurse 1 February 2019; 39 (1): 15–25. doi: https://doi.org/10.4037/ccn2019309
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