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Post‐resuscitation care and in‐hospital post‐arrest therapies are an important factor affecting survival after OHCA and subsequent functional outcome [95]. Significant morbidity and mortality after OHCA are due to cerebral and cardiac dysfunction in what has been termed the ‘post‐cardiac arrest syndrome’ [96]. Despite initial coma after OHCA, subsequent neurologic recovery can be influenced by in‐hospital post‐arrest treatments [97–99].

In 2015, ILCOR recommended avoiding hypoxia and hyperoxia in adults with return of spontaneous circulation (ROSC) after cardiac arrest. Patients should receive 100% inspired oxygen until either the arterial oxygen saturation or the partial pressure of arterial oxygen can be measured reliably [86]. partial pressure of carbon dioxide should be maintained within a normal physiological range.

Post‐resuscitation care should be tailored to hemodynamic goals, including mean arterial pressure and systolic blood pressure. Targets are patient specific. The AHA recommends avoidance or correction of hypotension, previously defined as systolic blood pressure greater than 90 mmHg or mean arterial pressure less than 65 mmHg. Prophylactic administration of antiarrhythmic drugs after ROSC is not recommended.

ILCOR recommends targeted temperature management, maintaining a constant temperature between 32 and 36 degrees C, in adults after ROSC from both shockable and non‐shockable rhythms, and the avoidance or treatment of fever after this [86]. They recommend that targeted temperature management is maintained for at least 24 hours post‐ROSC, but routine prehospital initiation with large volumes of cold intravenous fluid should not take place. Finally, they recommend against both routine seizure prophylaxis, although seizures should be treated, and modification of standard glucose management protocols.