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Pathophysiology and causes of cardiac arrest 

Pathophysiology and causes of cardiac arrest
Pathophysiology and causes of cardiac arrest

Peter Thomas Morley

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date: 19 May 2022

Sudden cardiopulmonary arrest (CPA) is still the commonest cause of death globally. CPAs are usually categorized according to where they occur, with out-of-hospital arrests accounting for approximately 75% of CPA deaths and in-hospital the remaining 25%. The arrests are also sub-categorized according to the initial rhythm, with the best outcomes associated with shockable rhythms. Large registries have demonstrated a variable incidence of out-of-hospital CPAs in adults (50–150/100,000 person years), with a range of outcomes (3–16% survival to hospital discharge). The majority of CPAs in adults are due to cardiac causes, but teaching surrounding the management of cardiac arrests now includes an increased focus on the identification and correction of underlying causes, irrespective of the rhythm. While identifying an underlying cause is often challenging, this is probably one of reasons explaining the improved survival seen with in-hospital compared with the out-of-hospital CPA. The incidence of CPAs in children is highest in infants, and decreases with age. The majority of CPAs in children are due to respiratory causes. Cardiac causes in children and young adults include a variety of familial, genetic, and acquired conditions. The pathophysiology of cardiac arrests is also now better understood. A large number of biochemical pathways are activated as a result of the CPA. These result in the post-cardiac arrest syndrome, which affects many systems in the body, but in particular the brain, heart, and kidneys.

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