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“It is ludicrous to commit tremendous fiscal and personnel resources to evaluating therapies for improving survival from the cardiac arrest event itself without acknowledging that the current state of post resuscitation care is widely variable and most often performed by clinicians unfamiliar with specific post resuscitation medical care.” – Peberdy

There has been a consistent pattern of improved short-term survival from cardiac arrest that more often than not does not translate into a significantly increased neurologically intact, long-term survival. Is post resuscitation care then the missing link in the Chain of Survival, as Peberdy suggests? The only guidelines from the American Heart Association for this time period are those for Therapeutic Hypothermia after Cardiac Arrest, implemented in many hospitals. Scientific studies are elucidating the phenomena of global ischemic brain damage and myocardial dysfunction during the reperfusion phase following cardiac arrest. Several clinicians now suggest that more aggressive standardized post resuscitation treatment protocols be followed and that these be scientifically tested. The ultimate goals are to improve dismal survival rates, restore quality of life to the cardiac arrest survivors and determine the prognosis at the appropriate time so that best-care decisions can be made.

(Peberdy, M.A. & Ornato, J.P. Post-resuscitation care: Is it the missing link in the Chain of Survival? Resuscitation 2005;64:135-137.)