Return of spontaneous circulation
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]
Synonyms and keywords: ROSC
Overview
Return of spontaneous circulation (ROSC) is resumption of sustained perfusing cardiac activity associated with significant respiratory effort after cardiac arrest.[1] Signs of ROSC include breathing, coughing, or movement and a palpable pulse or a measurable blood pressure. Cardiopulmonary resuscitation and defibrillation increase the chances of ROSC.[1] Lazarus phenomenon or autoresuscitation after failed cardiopulmonary resuscitation is the spontaneous return of circulation after resuscitation attempts have stopped in someone with cardiac arrest.[2][3] Thus passive monitoring is recommended for 10 minutes after resuscitation attempts have stopped.[2]
Return of Spontaneous Circulation
Fever After Cardiac Arrest
Hyperthermia following cardiac arrest is reported in 42% of the cases and is associated with worse neurological status and poor prognosis.[4] In fact, induced therapeutic hypothermia is part of the management of patients following cardiac arrest.[4]
The pathophysiology of fever following cardiac arrest is thought to be explained by an early systemic inflammatory response syndrome.[5] Cardiac arrest causes ischemia and reperfusion injury of the whole body leading to an activated inflammatory response. Post cardiac arrest patients are reported to have elevated cytokines, dysregulated cytokine production, and increased plasma endotoxins, which mimic the immunological abnormalities in sepsis.[6]
References
- ↑ 1.0 1.1 Jacobs I, Nadkarni V, Bahr J; et al. (November 2004). "Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries: a statement for healthcare professionals from a task force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian Resuscitation Council, New Zealand Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Councils of Southern Africa)". Circulation. 110 (21): 3385–97. doi:10.1161/01.CIR.0000147236.85306.15. PMID 15557386.
- ↑ 2.0 2.1 Wiese CH, Bartels UE, Orso S, Graf BM (April 2010). "[Lazarus phenomenon. Spontaneous return of circulation after cardiac arrest and cessation of resuscitation attempts]". Anaesthesist (in German). 59 (4): 333–41. doi:10.1007/s00101-010-1709-7. PMID 20224948.
- ↑ Hornby K, Hornby L, Shemie SD (May 2010). "A systematic review of autoresuscitation after cardiac arrest". Crit. Care Med. 38 (5): 1246–53. doi:10.1097/CCM.0b013e3181d8caaa. PMID 20228683.
- ↑ 4.0 4.1 Gebhardt K, Guyette FX, Doshi AA, Callaway CW, Rittenberger JC, Post Cardiac Arrest Service (2013). "Prevalence and effect of fever on outcome following resuscitation from cardiac arrest". Resuscitation. 84 (8): 1062–7. doi:10.1016/j.resuscitation.2013.03.038. PMID 23619740.
- ↑ Peberdy MA, Callaway CW, Neumar RW, Geocadin RG, Zimmerman JL, Donnino M; et al. (2010). "Part 9: post-cardiac arrest care: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 122 (18 Suppl 3): S768–86. doi:10.1161/CIRCULATIONAHA.110.971002. PMID 20956225.
- ↑ Adrie C, Laurent I, Monchi M, Cariou A, Dhainaou JF, Spaulding C (2004). "Postresuscitation disease after cardiac arrest: a sepsis-like syndrome?". Curr Opin Crit Care. 10 (3): 208–12. PMID 15166838.