0000000000628069
AUTHOR
Karl H. Lindner
Was ist neu in der kardiopulmonalen Reanimation?
A strong consensus was reached for several changes in the guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiac care (ECC) in the 1992 conference on CPR and ECC held by the Emergency Cardiac Care Committee of the American Heart Association. These new recommendations, together with differing recommendations of the European Resuscitation Council, are described. An unresponsive person with spontaneous respirations should be placed in the recovery position if no cervical trauma is suspected. Compared with endotracheal intubation, other airway-protecting devices such as combination esophageal-tracheal tubes are of minor acceptance. During ventilation, the time for filling the …
Use of an inspiratory impedance threshold valve during chest compressions without assisted ventilation may result in hypoxaemia
Although the concept of intermittent airway occlusion with the inspiratory impedance threshold valve (ITV) is a well-recognised strategy for improving efficiency of cardiopulmonary resuscitation (CPR), little is known about possible pulmonary side effects.After a baseline chest CT-scan, 24 pigs with beating hearts undergoing apnoeic oxygenation received an injection of a contrast medium and were then assigned randomly to either active compression-decompression CPR with ITV (ACD ITV CPR), ACD CPR alone, or standard-CPR with ITV (standard-ITV CPR), or standard-CPR alone. After a maximum of 5 min of chest compressions or if oxygen saturation dropped below 70%, the experiment was stopped, haemo…
Comparison of Standard Cardiopulmonary Resuscitation Versus the Combination of Active Compression-Decompression Cardiopulmonary Resuscitation and an Inspiratory Impedance Threshold Device for Out-of-Hospital Cardiac Arrest
Background— Active compression-decompression (ACD) CPR combined with an inspiratory impedance threshold device (ITD) improves vital organ blood flow during cardiac arrest. This study compared survival rates with ACD+ITD CPR versus standard manual CPR (S-CPR). Methods and Results— A prospective, controlled trial was performed in Mainz, Germany, in which a 2-tiered emergency response included early defibrillation. Patients with out-of-hospital arrest of presumed cardiac pathogenesis were sequentially randomized to ACD+ITD CPR or S-CPR by the advanced life support team after intubation. Rescuers learned which method of CPR to use at the start of each work shift. The primary end point was 1-ho…
Vasopressin oder Adrenalin bei präklinischem Herz-Kreislauf-Stillstand
Da eine Reihe von Untersuchungen nicht zeigen konnte, das Adrenalin mit einem Uberleben bei der Herz-Lungen-Wiederbelebung (HLW) korreliert, erscheint die Untersuchung eines alternativen Vasopressors bei der HLW sinnvoll. Die uber Vasopressin bekannten Daten aus experimentellen und klinischen Studien deuten darauf hin, das der Einsatz von Vasopressin der Therapie eines Kreislaufstillstandes mit Adrenalin uberlegen sein konnte. Eine europaische Multizenter-Studie unter der Schirmherrschaft des European Resuscitation Council (ERC) soll zeigen, ob Vasopressin dem herkommlichen Medikament Adrenalin bei der praklinischen HLW uberlegen ist.