Why we should sedate unresponsive patients after resuscitation

Some studies recently identified early predictors of awakening within 12 h from cardiac arrest. Unfortunately., there is currently no way to identify early awakeners at the time of ROSC. Moreover, unresponsive patients who are unable to protect their airway after ROSC need intubation and appropriate sedation. Opioids, proposed as an alternative to sedation to avoid coughing, have significant sedative effect. Regardless of their conscious state, patients who are resuscitated from cardiac arrest may need sedation because of respiratory insufficiency or cardiovascular instability, both of which are very common after resuscitation, and are a major cause of death. Sedation and maintaining normocapnia are necessary to prevent the consequences of brain oedema, which can develop shortly after ROSC and may lead to brain death.