Critical Care Management of Patients After Cardiac Arrest

Document Overview

Document Title

Critical Care Management of Patients After Cardiac Arrest

Authoring Societies

American Heart Association

Neurocritical Care Society

Document Publication Date

Nov 28, 2023

Page Last Reviewed/Updated

May 5, 2026

Document Type

Consensus Statement

Country of Publication

United States

Full Text Freely Available

Yes

Full Text Guideline

www.ahajournals.org/doi/10.1161/CIR.0000000000001163

Source Citation

Critical Care Management of Patients After Cardiac Arrest: A Scientific Statement From the American Heart Association and Neurocritical Care Society
Karen G. Hirsch, MDCo-Chair, Benjamin S. Abella, MD, MPhil, FAHA, Edilberto Amorim, MD, Mary Kay Bader, RN, MSN, FAHA, Jeffrey F. Barletta, PharmD, Katherine Berg, MD, Clifton W. Callaway, MD, PhD, FAHA, Hans Friberg, MD, PhD, Emily J. Gilmore, MD, David M. Greer, MD, FAHA, Karl B. Kern, MD, FAHA, Sarah Livesay, DNP, RN, Teresa L. May, DO, Robert W. Neumar, MD, PhD, FAHA, Jerry P. Nolan, MD, Mauro Oddo, MD, Mary Ann Peberdy, MD, FAHA, Samuel M. Poloyac, PharmD, PhD, David Seder, MD, FAHA, Fabio Silvio Taccone, MD, PhD, Anezi Uzendu, MD, Brian Walsh, PhD, RRT, Janice L. Zimmerman, MD, Romergryko G. Geocadin, MDCo-Chair, on behalf of the American Heart Association and Neurocritical Care Society

Supplemental Implementation Resources

• Quick-Reference Guide
• Algorithm

Document Scope, Criteria, and Use Cases

Document Objectives

The critical care management of patients after cardiac arrest is burdened by a lack of high-quality clinical studies and the resultant lack of high-certainty evidence. This results in limited practice guideline recommendations, which may lead to uncertainty and variability in management. Critical care management is crucial in patients after cardiac arrest and affects outcome. Although guidelines address some relevant topics (including temperature control and neurological prognostication of comatose survivors, 2 topics for which there are more robust clinical studies), many important subject areas have limited or nonexistent clinical studies, leading to the absence of guidelines or low-certainty evidence. The American Heart Association Emergency Cardiovascular Care Committee and the Neurocritical Care Society collaborated to address this gap by organizing an expert consensus panel and conference. Twenty-four experienced practitioners (including physicians, nurses, pharmacists, and a respiratory therapist) from multiple medical specialties, levels, institutions, and countries made up the panel. Topics were identified and prioritized by the panel and arranged by organ system to facilitate discussion, debate, and consensus building. Statements related to postarrest management were generated, and 80% agreement was required to approve a statement. Voting was anonymous and web based. Topics addressed include neurological, cardiac, pulmonary, hematological, infectious, gastrointestinal, endocrine, and general critical care management. Areas of uncertainty, areas for which no consensus was reached, and future research directions are also included. Until high-quality studies that inform practice guidelines in these areas are available, the expert panel consensus statements that are provided can advise clinicians on the critical care management of patients after cardiac arrest.

Scope

Management, Rehabilitation

Diseases/Conditions (MeSH)

D003422 - Critical Care

D006323 - Heart Arrest

D003422 - Critical Care

D006323 - Heart Arrest

Keywords

cardiac arrest, critical care, heart attack

Inclusion Criteria

Male, Female, Adolescent, Adult, Child, Older Adult

Health Care Settings

Emergency Care, Hospital, Outpatient

Intended Users

Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Number of Source Documents

274

Includes peer/external review process?

Yes

Includes public comment process?

No

Methodologist involvement?

Yes

Patient involvement?

No

Includes multi-disciplinary group?

Yes

Includes systematic review?

Yes

Grades quality of strength of evidence?

Yes

Grades quality of strength of recommendation?

Yes

Discloses funding source?

Yes

Discloses conflicts of interest?

Yes

Includes benefits/harms analysis with recommendations?

No