Achieving hemodynamic stabilization after return of spontaneous circulation

Bernd W. Böttiger

What is the optimal strategy of achieving hemodynamic stabilization after return of spontaneous circulation?

Bernd W. Böttiger: We do not have so many randomized controlled trials on this issue, but I would strongly suggest that one of the optimal strategies is replacement of volume.

Volume loading is a very important issue in the early phase, because cardiac arrest and cardiopulmonary resuscitation, global ischemia and reperfusion are a little bit like a sepsis-like syndrome. These patients need some volume at the beginning, and afterwards it depends. If you have impaired left ventricular function, you should probably use dobutamine. If you have basal dilation, you should probably use epinephrine or something which is associated with basal constriction.

So it is regular intensive therapy that is needed for hemodynamic stabilization in those patients.

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