Zusammenfassung
Die internationalen Richtlinien für die kardiopulmonale Reanimation unterliegen einem stetigen Wandel und wurden Anfang November 2005 überarbeitet. Der vorliegende Fallbericht beschreibt die präklinische kardiopulmonale Reanimation („cardiopulmonary resuscitation“, CPR) eines Patienten, der den Kreislaufstillstand nach Thoraxkompression (30:2), Maskenbeatmung sowie mehrmaliger biphasischer Defibrillation (1er-Schocks) ohne neurologische Folgeschäden überlebt hat und gibt einen praxisnahen Überblick über die wichtigsten Neuerungen der aktuellen Reanimationsleitlinien. Die durchgeführten Maßnahmen werden anhand der aktuellen Richtlinien hinterfragt und erläutert.
Abstract
The international guidelines for cardiopulmonary resuscitation are subject to continuous modification and were revised in November 2005. This report describes a case of an out-of-hospital cardiopulmonary resuscitation where the patient survived a cardiac arrest without neurological sequelae after chest compression (30:2), bag-mask ventilation and multiple biphasic defibrillation (single shocks). This article gives a practical review of the most important new recommendations in the current resuscitation guidelines. The accomplished measures are discussed on the background of the new recommendations.
Literatur
ECC Committee, Subcommittees and Task Forces of the American Heart Association (2005) 2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 112 [Suppl 24]: 1–211
European Resuscitation Council (2005) European Resuscitation Council guidelines for resuscitation 2005. Resuscitation 67: 1–189
Wik L, Hansen TB, Fylling F et al. (2003) Delaying defibrillation to give basic cardiopulmonary resuscitation to patients with out-of-hospital ventricular fibrillation: a randomized trial. JAMA 289: 1389–1395
Cobb LA, Fahrenbruch CE, Walsh TR et al. (1999) Influence of cardiopulmonary resuscitation prior to defibrillation in patients with out-of-hospital ventricular fibrillation. JAMA 281: 1182–1188
Kellum MJ, Kennedy KW, Ewy MD (2006) Cardiocerebral resuscitation improves survival of patients with out-of-hospital cardiac arrest. Am J Med 119: 335–340
Planta M von (1992) Kardiopulmonale Reanimation: Determinanten des Überlebens. Edition Medizin, VCH, Weinheim
Kern K, Hilwig R, Berb R et al. (2002) Importance of continuous chest compression during CPR. Circulation 105: 645–649
Wik L, Kramer-Johansen J, Myklebust H et al. (2005) Quality of cardiopulmonary resuscitation during out-of-hospital cardiac arrest. JAMA 293: 299–304
Abella BS, Alvarado JP, Myklebust H et al. (2005) Quality of cardiopulmonary resuscitation during in-hospital cardiac arrest. JAMA 293: 305–310
Goedecke A von, Bowden K, Keller C et al. (2005) Verkürzte Inspirationszeit während der Beatmung eines ungeschützten Atemweges. Effekt auf die Magen- und Lungenbeatmung im Simulationsmodell. Anaesthesist 54: 117–122
White RD, Blackwell TH, Russell JK et al. (2005) Transthoracic impedance does not affect defibrillation, resuscitation or survival in patients with out-of-hospital cardiac arrest treated with a non-escalating biphasic waveform defibrillator. Resuscitation 64: 63–69
Mittal S, Ayati S, Stein KM et al. (1999) Comparison of a novel rectilinear biphasic waveform with a damped sine wave monophasic for transthoracic ventricular defibrillator. J Am Cardiol 34: 1595–1601
Yu T, Weil MH, Tang W et al. (2002) Adverse outcomes of interrupted precordial compression during automated defibrillation. Circulation 106: 368–372
Hess EP, White RD (2005) Ventricular fibrillation is not provoked by chest compression during post-shock organized rhythms in out-of-hospital cardiac arrest. Resuscitation 66: 7–11
Morrison LJ, Verbeek PR, McDonald AC et al. (2000) Mortality and prehospital thrombolysis for acute myocardial infarction: a meta-analysis. JAMA 283: 2686–2692
Goedecke A von, Keller C, Wenzel V (2006) Maskenbeatmung als Rückzugsstrategie zur endotrachealen Intubation. Anaesthesist 55: 70–79
Pepe PE, Zachariah BS, Chandra NC (1993) Invasive airway techniques in resuscitation. Ann Emerg Med 22: 393–403
Wenzel V, Russo S, Arntz HR et al. (2006) Die neuen Reanimationsleitlinien 2005 des European Resuscitation Council – Kommentar und Ergänzung. Anaesthesist 55: 958–979
Spoehr F, Boettiger BW (2003) Safety of thrombolysis during cardiopulmonary resuscitation. Drug Saf 26: 367–379
Lederer W, Lichtenberger C, Pechlaner C et al. (2002) Recombinant tissue plasminogen activator during cardiopulmonary resuscitation in 108 patients with out-of-hospital cardiac arrest. Resuscitation 50: 71–76
Antman EM, Anbe DT, Armstrong PW et al. (2004) ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction – executive summary: a report of the ACC/AHA Task Force on Practice Guidelines. Circulation 110: 588–636
Sabatine MS (2005) Something old, something new: beta blockers and clopidogrel in acute myocardial infarction. Lancet 366: 1587–1589
ISIS-1 Collaborative Group (1986) Randomised trial of intravenous atenolol among 16027 cases of suspected acute myocardial infarction: ISIS-1. Lancet 2: 57–66
ISIS-1 Collaborative Group (1988) Mechanisms for the early mortality reduction produced by beta-blockade started early in acute myocardial infarction. Lancet 1: 921–923
Roberts R, Rogers WJ, Mueller HS et al. (1991) Immediate versus deferred beta-blockade following thrombolytic therapy in patients with acute myocardial infarction. Results of the Thrombolysis in Myocardial Infarction (TIMI) II.B-Study. Circulation 83: 422–437
Chen ZM, Pan HC, Chen YP et al. (2005) Early intravenous then oral metoprolol in 45,852 patients with acute myocardial infarction: randomised placebo-controlled trial. Lancet 366: 1622–1632
Interessenkonflikt
Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Eppinger, M., Flury, G., Wenzel, V. et al. Anwendung der aktuellen Reanimationsrichtlinien 2005. Anaesthesist 56, 1133–1136 (2007). https://doi.org/10.1007/s00101-007-1247-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00101-007-1247-0