Glucose

Hyperglycemia following cardiac arrest can increase the risk of death and brain injury. However, aggressive management of hyperglycemia increases the risk of significant hypoglycemia (glucose under 40 mg/dL), which is also associated with poor outcomes in these patients. There is clear evidence indicating the ideal range of blood glucose levels. (Class IIb, Evidence level B-R). Patients should be managed similarly to other patients needing intensive management.

Steroids

Corticosteroids are crucial to the stress response and help maintain vascular tonicity and permeability of the capillary vasculature. While cardiac arrest causes a stress response, it is unclear if corticosteroids provide a benefit to these patients. Therefore, these medications are not usually given to cardiac arrest patients who do not demonstrate adrenal insufficiencies. 

Hemofiltration

Hemofiltration can improve the body’s response to ischemia and reperfusion injuries following cardia arrest. However, the research is mixed with some studies showing no benefit after 6 months and others showing improved survival and neurologic outcomes. More research is needed to determine if this is beneficial in routine management following ROSC.