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Invited Commentary
Cardiology
July 10, 2020

Postresuscitation Management and Survival After Cardiac Arrest—The Whole Package

Author Affiliations
  • 1Department of Surgery, University of Utah Health, Salt Lake City
JAMA Netw Open. 2020;3(7):e2010921. doi:10.1001/jamanetworkopen.2020.10921

Survival after cardiac arrest depends on the physician’s or medical team’s ability to restore perfusion to the heart during the cardiac arrest. This is often accomplished through administering medications, providing artificial respirations, and performing closed chest compressions. For decades, we have learned that early and effective cardiopulmonary resuscitation (CPR) and defibrillation are associated with increased probability of return of spontaneous circulation1,2; simultaneously, we have observed repeatedly that the probability of survival with intact neurologic function is inversely correlated with the duration of closed chest compressions before return of spontaneous circulation.3,4 Fundamentally, these observations suggest that, in most cases, CPR is suboptimal at providing perfusion to the organs, leading to progressive metabolic derangement and tissue ischemia.

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