Update on advanced life support and resuscitation techniques.
نویسندگان
چکیده
PURPOSE OF REVIEW This article is a review of the most recent findings in resuscitation techniques in advanced cardiac life support. The article focuses particularly on the period after July 1, 2003, but relevant new findings before this period are also included. RECENT FINDINGS Randomized clinical trial results suggest that the current cardiopulmonary resuscitation and advanced cardiac life support guidelines may need to be modified. Early defibrillation during the electrical phase of cardiac arrest remains the most crucial intervention, but performing cardiopulmonary resuscitation before defibrillation may be more effective, as compared with immediate defibrillation, during the circulatory phase of cardiac arrest. Biphasic waveforms are superior to monophasic damped sine waveforms in achieving defibrillation. Novel cardiopulmonary resuscitation methods that increase negative intrathoracic pressure promote an increase in blood flow return to the heart. These devices have been correlated with improved short-term survival rates during the circulatory phase of cardiac arrest. Vasopressin administration, given alone or in combination with epinephrine, should be considered during the circulatory phase of out-of-hospital cardiac arrest, particularly in patients presenting with asystole as the initial rhythm. Induction of hypothermia during the metabolic phase in cardiac arrest survivors improves 6-month survival rates and neurologic outcomes. SUMMARY Strategies to improve the low survival outcomes of cardiac arrest victims are available. Clinical trials testing these strategies suggest benefit from certain interventions but are not definitive. These different therapeutic interventions should be performed in a phase-specific-oriented fashion according to the three-phase time-sensitive model of cardiac arrest.
منابع مشابه
Advanced life support update.
INTRODUCTION Cardiac arrest is a common emergency in acute hospitals. The Resuscitation Council (UK) Advanced Life Support Guidelines provide a systematic approach to cardiac arrest recognition, treatment and aftercare. This review provides an update on the current treatment guidelines and identifies areas where these may be strengthened. METHODS The evidence informing the 2005 Resuscitation ...
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متن کاملAdvanced cardiac life support update: the new ILCOR cardiovascular resuscitation guidelines. International Liaison Committee on Resuscitation.
In 1974 the first American Heart Association (AHA) and Emergency Cardiac Care (ECC) standards for resuscitation were published. At that time only a few of the recommended measures were based on scientific evidence, but the medical world accepted them as international precepts that formed the gold standard for resuscitation care. Although they had been evolved only on the basis of national exper...
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عنوان ژورنال:
- Current opinion in cardiology
دوره 20 1 شماره
صفحات -
تاریخ انتشار 2005