Return of spontaneous circulation after cardiac arrest

Return of spontaneous circulation is the resumption of a sustained heart rhythm that perfuses the body after cardiac arrest. 



It is commonly associated with significant respiratory effort. 



Signs of include breathing, coughing, or movement and a palpable pulse or a measurable blood pressure. 



Someone is considered to have sustained return of spontaneous circulation when circulation persists and cardiopulmonary resuscitation has ceased for at least 20 consecutive minutes.



The post-cardiac arrest syndrome is comprised of possible brain injury, myocardial dysfunction, systemic/reperfusion response, and persistent  pathology. 



It often requires resource intensive monitoring and lengthy treatment in the ICU.



Return of spontaneous circulation can be achieved through cardiopulmonary resuscitation and defibrillation. 



Return of circulation is not a predictor of a favorable long-term outcome. 



Patients have died shortly after their circulation has returned. 



Those who had suffered from an out-of-hospital cardiac arrest and had achieved return of spontaneous circulation, 38% of those people suffered a cardiac re-arrest before arriving at the hospital with an average time of 3 minutes to re-arrest.



Factors during cardiopulmonary resuscitation and defibrillation associated with success of achieving return of spontaneous circulation: the chest compression fraction, which is a measure of how much time during cardiac arrest are chest compressions performed, minimizing chest compression intervals before and after shocking a patient’s rhythm, which would in turn increase chest compression fraction, the presence of a shockable rhythm.



Lazarus phenomenon is the spontaneous return of circulation after cardiopulmonary resuscitation attempts have stopped in someone with cardiac arrest. This phenomenon most frequently occurs within 10 minutes of cessation of resuscitation, thus passive monitoring is recommended for 10 minutes.



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