Advances in resuscitation
| Autor: | Allan R. Mottram, Richard L. Page |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Fibrillation
medicine.medical_specialty Resuscitation business.industry Defibrillation medicine.medical_treatment Return of spontaneous circulation medicine.disease Cardiopulmonary Resuscitation Sudden cardiac death Death Sudden Cardiac Physiology (medical) Internal medicine Ventricular fibrillation Practice Guidelines as Topic medicine Cardiology Humans Cardiopulmonary resuscitation medicine.symptom Cardiology and Cardiovascular Medicine business Clinical death Algorithms Defibrillators |
| Zdroj: | Circulation. 126(8) |
| ISSN: | 1524-4539 |
| Popis: | Studies of sudden cardiac death (SCD) demonstrate overwhelmingly poor outcomes regardless of the population or intervention studied. Although SCD is a complex critical illness that is understood poorly, it is clear that outcomes are influenced by timely provision of high-quality, specific interventions.1,2 However, there is considerable heterogeneity within this group of patients with regard to the cause of SCD, comorbidities, and duration of the cardiac arrest event that can be difficult to identify during the course of resuscitation.3 These variables can have a significant bearing on outcomes and efficacy of treatment. For example, compression-only bystander cardiopulmonary resuscitation (CPR) may not be ideal for all subgroups of patients experiencing SCD. In addition, a proportion of SCD patients have a significant coronary artery lesion and benefit from percutaneous coronary intervention (PCI). Finally, post–ventricular fibrillation cardiac arrest patients may respond better to therapeutic hypothermia (TH) than those with other rhythms before the return of spontaneous circulation (ROSC).4–6 SCD is a dynamic, time-dependent process, as supported by research on CPR technique, early use of automated external defibrillators (AEDs), and implementation of TH.7–9 Weisfeldt and Becker10 elaborate on this concept in their 3-phase model of resuscitation from ventricular fibrillation cardiac arrest, describing progressive disruption of cardiac electrophysiology, circulation, and metabolism. The electric phase lasts from cardiac arrest through ≈4 minutes of resuscitation efforts and is considered the time when defibrillation is most likely to be successful. Herlitz et al11 demonstrated this in a prospective observational study of inpatients with ventricular fibrillation cardiac arrest. Those defibrillated within 3 minutes of collapse had significantly improved survival compared with those defibrillated >12 minutes from collapse. Work by Chan et al12 demonstrated similar findings, with a significant outcome benefit for inpatients sustaining ventricular fibrillation cardiac arrest … |
| Databáze: | OpenAIRE |
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