Postcardiac arrest myocardial dysfonction

Abstract

Post-resuscitation myocardial dysfunction (PRMD) is a frequent complication, which worsens hemodynamic status and may be lethal by itself. Early identification and treatment of this cardiac complication is one of the key-targets of support during hospitalization of these patients. Easy to identify using echocardiography, PRMD usually begins early after the resuscitation, and is completely reversible within 48 to 72 hours. Its presentation associates myocardial systolic and diastolic dysfunctions, even in the absence of coronary cause. However, detection and treatment of myocardial ischemia should be systematically performed when a coronary cause of cardiac arrest is suspected. To date, the most recommended treatment for systolic dysfunction remains dobutamine since no other pharmacological agents demonstrated its superiority in this setting. In the most severe cases, a mechanical circulatory assistance should be considered providing that neurological prognosis is not compromised.