Patients successfully resuscitated from cardiac arrest often have brain injury, myocardial dysfunction, and systemic ischemia–reperfusion injury, collectively termed the post-cardiac arrest syndrome (PCAS). To improve outcomes, potential therapies must be able to be administered early in the post-arrest course and provide broad cytoprotection, as ischemia–reperfusion injury affects all organ systems. Our understanding of the immune system contributions to the PCAS has expanded, with animal models detailing biologically plausible mechanisms of secondary injury, the protective effects of available immunomodulatory drugs, and how immune dysregulation underlies infection susceptibility after arrest. In this narrative review, we discuss the dysregulated immune response in PCAS, human trials of targeted immunomodulation therapies, and future directions for immunomodulation following cardiac arrest.

心脏骤停后成功复苏的患者通常有脑损伤、心肌功能障碍和全身缺血再灌注损伤，统称为心脏骤停后综合征（PCAS）。为了改善结果，必须能够在逮捕后早期进行潜在的治疗并提供广泛的细胞保护，因为缺血再灌注损伤会影响所有器官系统。我们对免疫系统对 PCAS 的贡献的理解得到了扩展，动物模型详细说明了继发性损伤的生物学合理机制、可用免疫调节药物的保护作用以及如何免疫失调是逮捕后感染易感性的基础。在这篇叙述性综述中，我们讨论了 PCAS 中失调的免疫反应、靶向免疫调节疗法的人体试验以及心脏骤停后免疫调节的未来方向。