[Preclinical management of cardiac arrest-extracorporeal cardiopulmonary resuscitation].
Präklinisches Management bei Herz-Kreislauf-Stillstand – extrakorporale kardiopulmonale Reanimation.
Chain-of-survival
Extracorporeal membrane oxygenation
Out-of-hospital cardiac arrest
Resuscitation
eCPR
Journal
Der Anaesthesist
ISSN: 1432-055X
Titre abrégé: Anaesthesist
Pays: Germany
ID NLM: 0370525
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
pubmed:
22
5
2020
medline:
23
6
2021
entrez:
22
5
2020
Statut:
ppublish
Résumé
The chances of surviving out-of-hospital cardiac arrest (OHCA) are still very low. Despite intensive efforts the outcome has remained relatively poor over many years. In specific situations, new technologies, such as extracorporeal cardiopulmonary resuscitation (eCPR) could significantly improve survival with a good neurological outcome. Does the immediate restoration of circulation and reoxygenation via eCPR influence the survival rate after OHCA? Is eCPR the new link in the chain of survival? Discussion of current study results and guideline recommendations. The overall survival rates after OHCA have remained at 10-30% over many years. Despite low case numbers more recent retrospective studies showed that an improved outcome can be achieved with eCPR. In selected patient collectives survival with a favorable neurological outcome is possible in 38% of the cases. Survival after cardiac arrest and the subsequent quality of life dependent on many different factors. The time factor, i.e. the avoidance of a no-flow phase and reduction of the low-flow phase is of fundamental importance. The immediate restoration of the circulation and oxygen supply by eCPR can significantly improve survival; however, large randomized, controlled trials are currently not available.
Sections du résumé
BACKGROUND
The chances of surviving out-of-hospital cardiac arrest (OHCA) are still very low. Despite intensive efforts the outcome has remained relatively poor over many years. In specific situations, new technologies, such as extracorporeal cardiopulmonary resuscitation (eCPR) could significantly improve survival with a good neurological outcome.
OBJECTIVE
Does the immediate restoration of circulation and reoxygenation via eCPR influence the survival rate after OHCA? Is eCPR the new link in the chain of survival?
MATERIAL AND METHODS
Discussion of current study results and guideline recommendations.
RESULTS
The overall survival rates after OHCA have remained at 10-30% over many years. Despite low case numbers more recent retrospective studies showed that an improved outcome can be achieved with eCPR. In selected patient collectives survival with a favorable neurological outcome is possible in 38% of the cases.
CONCLUSION
Survival after cardiac arrest and the subsequent quality of life dependent on many different factors. The time factor, i.e. the avoidance of a no-flow phase and reduction of the low-flow phase is of fundamental importance. The immediate restoration of the circulation and oxygen supply by eCPR can significantly improve survival; however, large randomized, controlled trials are currently not available.
Identifiants
pubmed: 32435820
doi: 10.1007/s00101-020-00787-6
pii: 10.1007/s00101-020-00787-6
doi:
Types de publication
Journal Article
Review
Langues
ger
Sous-ensembles de citation
IM