Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Crit Care Med. Feb 4, 2012; 1(1): 4-9
Published online Feb 4, 2012. doi: 10.5492/wjccm.v1.i1.4
Post-cardiac arrest syndrome: Mechanisms and evaluation of adrenal insufficiency
Athanasios Chalkias, Theodoros Xanthos
Athanasios Chalkias, Theodoros Xanthos, Department of Anatomy, Medical School, University of Athens, 11527 Athens, Greece
Author contributions: Chalkias A and Xanthos T equally contributed to this paper.
Correspondence to: Theodoros Xanthos, PhD, President “Hellenic Society of Cardiopulmonary Resuscitation”, Department of Anatomy, Medical School, University of Athens, 11527 Athens, Greece. theodorosxanthos@yahoo.com
Telephone: +30-210-7462387 Fax: +30-210-7462305
Received: July 12, 2011
Revised: October 18, 2011
Accepted: December 21, 2011
Published online: February 4, 2012

Cardiac arrest is one of the leading causes of death and represents maximal stress in humans. After restoration of spontaneous circulation, post-cardiac arrest syndrome is the predominant disorder in survivors. Besides the post-arrest brain injury, the post-resuscitation myocardial stunning, and the systemic ischemia/reperfusion response, this syndrome is characterized by adrenal insufficiency, a disorder that often remains undiagnosed. The pathophysiology of adrenal insufficiency has not been elucidated. We performed a comprehensive search of three medical databases in order to describe the major pathophysiological disturbances which are responsible for the occurrence of the disorder. Based on the available evidence, this article will help physicians to better evaluate and understand the hidden yet deadly post-cardiac arrest adrenal insufficiency.

Keywords: Adrenal insufficiency, Cardiac arrest, Post-resuscitation period, Post-cardiac arrest syndrome