Back to basics for out-of-hospital cardiac arrest

Research output: Contribution to journalComment/debateResearchpeer-review

Over the past 20 years, much effort has been put into advanced in-hospital care for patients resuscitated after out-of-hospital cardiac arrest (OHCA), including centralisation of care at dedicated cardiac arrest centres.1 Observational studies have reported better outcomes for patients treated at such centres than those treated at local hospitals.2 Large clinical trials have provided evidence that patients with OHCA (without cardiogenic shock or ST-elevation myocardial infarction [STEMI]) do not benefit from acute angiography, hypothermia, control or rigorous blood pressure or oxygenation control, and randomised clinical trial evidence supporting the use of mechanical support is still scarce.3, 4, 5, 6 Concurrently, the importance of multimodal neuroprognostication has become increasingly clear and, particularly, the value of allowing time for the patient to recover, to avoid premature termination of therapy. Still, the question that remains is whether patients who achieved return of sustained spontaneous circulation (ROSC) without STEMI after OHCA benefit from direct transport to specialised cardiac arrest centres as opposed to being taken to a closer local hospital with basic emergency and intensive care.
Original languageEnglish
JournalThe Lancet
Volume402
Issue number10410
Pages (from-to)1300-1301
Number of pages2
ISSN0140-6736
DOIs
Publication statusPublished - 2023

ID: 375055780