Skip to main content
SpringerLink
Log in

ERC-Leitlinien 2021 zur kardiopulmonalen Reanimation

ERC guidelines 2021 on cardiopulmonary resuscitation

  • Schwerpunkt
  • Published:
Herz Aims and scope Submit manuscript

Zusammenfassung

Im Jahr 2021 wurden die aktuellen europäischen Leitlinien zur kardiopulmonalen Reanimation veröffentlicht. Die Leitlinie, welche in 12 Kapitel unterteilt ist, wurde um die Kapitel „Epidemiologie“ und „Lebensrettende Systeme“ erweitert. Im folgenden Beitrag wird auf die Empfehlungen zu Basismaßnahmen, erweiterten Maßnahmen der Erwachsenenreanimation und auf die Postreanimationsbehandlung eingegangen.

Abstract

The current European guidelines on cardiopulmonary resuscitation were published in 2021. The guidelines, which are structured in 12 chapters, were supplemented with the chapters on epidemiology and life-saving systems. In the following article, the recommendations on basic life support, advanced measures for resuscitation in adults and postresuscitation treatment are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3

Literatur

  1. Gräsner JT, Herlitz J, Tjelmeland IBM et al (2021) European resuscitation council guidelines 2021: epidemiology of cardiac arrest in europe. Resuscitation 161:61–79

    PubMed  Google Scholar 

  2. Fischer M, Wnent J, Gräsner JT et al (2021) Öffentlicher Jahresbericht 2020 des Deutschen Reanimationsregisters: Außerklinische Reanimation 2020. www.reanimationsregister.de/berichte. Zugegriffen: 11. Okt. 2021

  3. Hawkes C, Booth S, Ji C et al (2017) Epidemiology and outcomes from out-of-hospital cardiac arrests in England. Resuscitation 110:133–140

    PubMed  Google Scholar 

  4. Spangenberg T, Schewel J, Dreher A et al (2018) Health related quality of life after extracorporeal cardiopulmonary resuscitation in refractory cardiac arrest. Resuscitation 127:73–78

    CAS  PubMed  Google Scholar 

  5. Kuisma M, Alaspää A (1997) Out-of-hospital cardiac arrests of non-cardiac origin. Epidemiology and outcome. Eur Heart J 18(7):1122–1128

    CAS  PubMed  Google Scholar 

  6. Hess EP, Campbell RL, White RD (2007) Epidemiology, trends, and outcome of out-of-hospital cardiac arrest of non-cardiac origin. Resuscitation 72(2):200–206

    PubMed  Google Scholar 

  7. Sandroni C, Nolan J, Cavallaro F, Antonelli M (2007) In-hospital cardiac arrest: Incidence, prognosis and possible measures to improve survival. Intensive Care Med 33:237–245

    PubMed  Google Scholar 

  8. Karam N, Marijon E, Dumas F et al (2017) Characteristics and outcomes of out-of-hospital sudden cardiac arrest according to the time of occurrence. Resuscitation 116:16–21

    PubMed  Google Scholar 

  9. Perkins GD, Graesner JT, Semeraro F et al (2021) European resuscitation council guidelines 2021: executive summary. Resuscitation 161:1–60

    PubMed  Google Scholar 

  10. Semeraro F, Greif R, Böttiger BW et al (2021) European resuscitation council guidelines 2021: systems saving lives. Resuscitation 161:80–97

    PubMed  Google Scholar 

  11. Olasveengen TM, Semeraro F, Ristagno G et al (2021) European resuscitation council guidelines 2021: basic life support. Resuscitation 161:98–114

    PubMed  Google Scholar 

  12. Soar J, Böttiger BW, Carli P et al (2021) European resuscitation council guidelines 2021: adult advanced life support. Resuscitation 161:115–151

    PubMed  Google Scholar 

  13. Lott C, Truhlář A, Alfonzo A et al (2021) European resuscitation council guidelines 2021: cardiac arrest in special circumstances. Resuscitation 161:152–219

    PubMed  Google Scholar 

  14. Nolan JP, Sandroni C, Böttiger BW et al (2021) European resuscitation council and European society of intensive care medicine guidelines 2021: post-resuscitation care. Intensive Care Med 47(4):369–421

    PubMed  PubMed Central  Google Scholar 

  15. Zideman DA, Singletary EM, Borra V et al (2021) European resuscitation council guidelines 2021: first aid. Resuscitation 161:270–290

    PubMed  Google Scholar 

  16. Madar J, Roehr CC, Ainsworth S et al (2021) European resuscitation council guidelines 2021: newborn resuscitation and support of transition of infants at birth. Resuscitation 161:291–326

    PubMed  Google Scholar 

  17. Van de Voorde P, Turner NM, Djakow J et al (2021) European resuscitation council guidelines 2021: paediatric life support. Resuscitation 161:327–387

    PubMed  Google Scholar 

  18. Greif R, Lockey A, Breckwoldt J et al (2021) European resuscitation council guidelines 2021: education for resuscitation. Resuscitation 161:388–407

    PubMed  Google Scholar 

  19. Mentzelopoulos SD, Couper K, Voorde PV et al (2021) European resuscitation council guidelines 2021: ethics of resuscitation and end of life decisions. Resuscitation 161:408–432

    PubMed  Google Scholar 

  20. Okubo M, Komukai S, Callaway CW, Izawa J (2021) Association of timing of epinephrine administration with outcomes in adults with out-of-hospital cardiac arrest. JAMA Netw Open 4(8):e2120176

    PubMed  PubMed Central  Google Scholar 

  21. Bughrara N, Herrick SL, Leimer E et al (2020) Focused cardiac ultrasound and the periresuscitative period: a case series of resident-performed echocardiographic assessment using subcostal-only view in advanced life support. A A Pract 14(10):e1278

    PubMed  Google Scholar 

  22. Taylor B, Joshi B, Hutchison L, Manivel V (2020) Echocardiography does not prolong peri-shock pause in cardiopulmonary resuscitation using the COACH-RED protocol with non-expert sonographers in simulated cardiac arrest. Resusc Plus 4:100047

    PubMed  PubMed Central  Google Scholar 

  23. Michels G, Zinke H, Möckel M et al (2017) Recommendations for education in ultrasound in medical intensive care and emergency medicine: position paper of DGIIN, DEGUM and DGK. Kardiologe 11:285–290

    Google Scholar 

  24. Young ML, Exelbert EJ, Roth T, Cohen L, Cogan J (2020) External cardioversion-defibrillation with pushing down on the chest wall to increase the success rate in obese patients. Am J Case Rep 21:e927009

    PubMed  PubMed Central  Google Scholar 

  25. Perkins GD, Kenna C, Ji C et al (2020) The influence of time to adrenaline administration in the paramedic 2 randomised controlled trial. Intensive Care Med 46(3):426–436

    CAS  PubMed  PubMed Central  Google Scholar 

  26. Ewy GA, Bobrow BJ, Chikani V et al (2015) The time dependent association of adrenaline administration and survival from out-of-hospital cardiac arrest. Resuscitation 96:180–185

    PubMed  Google Scholar 

  27. Hagihara A, Hasegawa M, Abe T et al (2012) Prehospital epinephrine use and survival among patients with out-of-hospital cardiac arrest. JAMA 307(11):1161–1168

    CAS  PubMed  Google Scholar 

  28. Hansen M, Schmicker RH, Newgard CD et al (2018) Time to epinephrine administration and survival from nonshockable out-of-hospital cardiac arrest among children and adults. Circulation 137(19):2032–2040

    PubMed  PubMed Central  Google Scholar 

  29. Donnino MW, Salciccioli JD, Howell MD et al (2014) Time to administration of epinephrine and outcome after in-hospital cardiac arrest with non-shockable rhythms: retrospective analysis of large in-hospital data registry. BMJ 348:g3028

    PubMed  PubMed Central  Google Scholar 

  30. Konstantinides SV, Meyer G, Becattini C et al (2020) 2019 ESC guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European respiratory society (ERS). Eur Heart J 41(4):543–603

    PubMed  Google Scholar 

  31. Bakkum MJ, Schouten VL, Smulders YM et al (2021) Accelerated treatment with rtPA for pulmonary embolism induced circulatory arrest. Thromb Res 203:74–80

    CAS  PubMed  Google Scholar 

  32. Michels G, Wengenmayer T, Hagl C et al (2019) Recommendations for extracorporeal cardiopulmonary resuscitation (eCPR): consensus statement of DGIIN, DGK, DGTHG, DGfK, DGNI, DGAI, DIVI and GRC. Clin Res Cardiol 108(5):455–464

    PubMed  Google Scholar 

  33. Richardson ASC, Tonna JE, Nanjayya V et al (2021) Extracorporeal cardiopulmonary resuscitation in adults. Interim guideline consensus statement from the extracorporeal life support organization. ASAIO J 67(3):221–228

    PubMed  Google Scholar 

  34. Pancaro C, Shah N, Pasma W et al (2020) Risk of major complications after perioperative norepinephrine infusion through peripheral intravenous lines in a multicenter study. Anesth Analg 131(4):1060–1065

    PubMed  Google Scholar 

  35. McDonagh TA, Metra M, Adamo M et al (2021) 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 42(36):3599–3726

    CAS  PubMed  Google Scholar 

  36. Ibanez B, James S, Agewall S et al (2018) 2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the task force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European society of cardiology (ESC). Eur Heart J 39(2):119–177

    PubMed  Google Scholar 

  37. Collet JP, Thiele H, Barbato E et al (2021) 2020 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J 42(14):1289–1367

    PubMed  Google Scholar 

  38. Lemkes JS, Janssens GN, van der Hoeven NW et al (2019) Coronary angiography after cardiac arrest without ST-segment elevation. N Engl J Med 380:1397–1407

    PubMed  Google Scholar 

  39. Desch S, Freund A, Graf T et al (2019) Immediate unselected coronary angiography versus delayed triage in survivors of out-of-hospital cardiac arrest without ST-segment elevation: design and rationale of the TOMAHAWK trial. Am Heart J 209:20–28

    PubMed  Google Scholar 

  40. Dankiewicz J, Cronberg T, Lilja G et al (2021) Hypothermia versus normothermia after out-of-hospital cardiac arrest. N Engl J Med 384(24):2283–2294

    PubMed  Google Scholar 

  41. Bernard SA, Gray TW, Buist MD et al (2002) Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med 346:557–563

    PubMed  Google Scholar 

  42. Hypothermia after Cardiac Arrest Study Group (2002) Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 346:549–556

    Google Scholar 

  43. Nielsen N, Wetterslev J, Cronberg T et al (2013) Targeted temperature management at 33 degrees C versus 36 degrees C after cardiac arrest. N Engl J Med 369:2197–2206

    CAS  PubMed  Google Scholar 

  44. Adler C, Michels G (2021) The end of an era? Target temperature management after out-of-hospital cardiac arrest. Med Klin Intensivmed Notfmed. https://doi.org/10.1007/s00063-021-00865-6

    Article  PubMed  Google Scholar 

  45. Laver S, Farrow C, Turner D, Nolan J (2004) Mode of death after admission to an intensive care unit following cardiac arrest. Intensive Care Med 30(11):2126–2128

    PubMed  Google Scholar 

  46. Lemiale V, Dumas F, Mongardon N et al (2013) Intensive care unit mortality after cardiac arrest: the relative contribution of shock and brain injury in a large cohort. Intensive Care Med 39(11):1972–1980

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinik für Akut- und Notfallmedizin, St.-Antonius-Hospital Eschweiler, Akademisches Lehrkrankenhaus der RWTH Aachen, Dechant-Deckers-Str. 8, 52249, Eschweiler, Deutschland

    Guido Michels

  2. Herzzentrum Leipzig, Universität Leipzig, Leipzig, Deutschland

    Janine Pöss & Holger Thiele

Authors
  1. Guido Michels
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Janine Pöss
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Holger Thiele
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Guido Michels.

Ethics declarations

Interessenkonflikt

G. Michels ist Sprecher der Arbeitsgruppe Kardiopulmonale Reanimation (AG42), stellvertretender Sprecher des Cluster A: Kardiovaskuläre Akut- und Intensivmedizin und Sprecher des Arbeitskreises Mechanische Kreislaufunterstützung (AK-MCS) der Arbeitsgruppe Interventionelle Kardiologie der Deutschen Gesellschaft für Kardiologie e. V. (DGK); kooptiertes Vorstandsmitglied der Deutschen Gesellschaft für Internistische Intensivmedizin und Notfallmedizin e. V. (DGIIN); er erhielt gelegentlich Honorare für Vortragstätigkeiten von Pfizer, Novartis, Servier, Zoll, Getinge und Orion Pharma sowie Drittmittel von der Kardiologischen Versorgungsforschung der DGK e. V. (DGK-ZfKVF). Die Interessenkonflikte stehen in keinem Zusammenhang mit der vorliegenden Arbeit. H. Thiele ist Incoming Präsident der Deutschen Gesellschaft für Kardiologie e. V. (DGK), früherer Cluster Sprecher des Clusters A: Kardiovaskuläre Akut- und Notfallmedizin der DGK und Task Force Mitglied für die Zertifizierung der Cardiac Arrest Zentren in Deutschland. Er hat keine Einnahmen durch Vorträge oder als Berater und keine Interessenkonflikte in Zusammenhang mit der vorliegenden Arbeit. J. Pöss gibt an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Additional information

Anmerkung/Hinweis

Aus Gründen der besseren Lesbarkeit und Verständlichkeit der Texte wird in Springer-Publikationen in der Regel das generische Maskulinum als geschlechtsneutrale Form verwendet. Diese Form impliziert immer alle Geschlechter.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Michels, G., Pöss, J. & Thiele, H. ERC-Leitlinien 2021 zur kardiopulmonalen Reanimation. Herz 47, 4–11 (2022). https://doi.org/10.1007/s00059-021-05082-7

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00059-021-05082-7

Schlüsselwörter

Keywords

Search

Navigation