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Fokus Notfallmedizin 2022/2023 – Zusammenfassung ausgewählter notfallmedizinischer Studien

Focus emergency medicine 2022/2023—Summary of selected studies in emergency medicine

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Abbreviations

CPC:

„Cerebral performance category“

DSED:

„Double sequence external defibrillation“

ECMO:

„Extracorporeal membrane oxygenation“ (extrakorporale Membranoxygenierung)

eCPR:

„Extracorporeal cardiopulmonary resuscitation“

EK:

Erythrozytenkonzentrat

ERC:

European Resuscitation Council

ESICM:

European Society of Intensive Care Medicine

FFP:

Gefrorenes Frischplasma

FIO2 :

Inspiratorische Sauerstofffraktion

INR:

International Normalized Ratio

KI:

Konfidenzintervall

LyoPlas:

Lyophilisiertes Plasma

MAP:

„Mean arterial pressure“ (mittlerer arterieller Blutdruck)

mRS:

Modified Ranking Scale

NSE:

Neuronenspezifische-Enolase

OHCA:

„Out of hospital cardiac arrest“ (außerklinischer Kreislaufstillstand)

OR:

„Odds ratio“

paO2 :

Arterieller Sauerstoffpartialdruck

RCT:

Randomisierte kontrollierte Studie

ROS:

Reaktive Sauerstoffspezies

ROSC:

„Return of spontaneous circulation“

RR:

„Relative risk“

SaO2 :

Arterielle Sauerstoffsättigung

SAPS 3:

Simplified Acute Physiology Score 3

SIRS:

„Systemic inflammatory response syndrome“

sPAP:

„Systolic pulmonary artery pressure“ (systolischer pulmonalarterieller Druck)

SpO2 :

Periphere Sauerstoffsättigung

TAPSE:

„Tricuspid annular plane systolic excursion“

TDI:

„Tissue Doppler imaging“

va-ECMO:

Venoarterielle EMCO

VC:

„Vector change“

VCI:

Vena cava inferior

Literatur

  1. Belohlavek J, Smalcova J, Rob D, Franek O, Smid O, Pokorna M et al (2022) Effect of intra-arrest transport, extracorporeal cardiopulmonary resuscitation, and immediate invasive assessment and treatment on functional neurologic outcome in refractory out-of-hospital cardiac arrest. A randomized clinical trial. JAMA 327:737–747. https://doi.org/10.1001/jama.2022.1025

    Article  PubMed  PubMed Central  Google Scholar 

  2. Yannopoulos D, Bartos J, Raveendran G, Walser E, Connett J, Murray TA et al (2020) Advanced reperfusion strategies for patients with out-of-hospital cardiac arrest and refractory ventricular fibrillation (ARREST): a phase 2, single centre, open-label, randomised controlled trial. Lancet 6736:1–10. https://doi.org/10.1016/S0140-6736(20)32338-2

    Article  Google Scholar 

  3. Hsu CH, Meurer WJ, Domeier R, Fowler J, Whitmore SP, Bassin BS et al (2021) Extracorporeal cardiopulmonary resuscitation for refractory out-of-hospital cardiac arrest (EROCA): results of a randomized feasibility trial of expedited out-of-hospital transport. Ann Emerg Med 78:92–101. https://doi.org/10.1016/j.annemergmed.2020.11.011

    Article  PubMed  PubMed Central  Google Scholar 

  4. Suverein MM, Delnoij TSR, Lorusso R, Bravo B, Bruinsma GJ, Otterspoor L, Elzo Kraemer CV et al (2023) Early extracorporeal CPR for refractory out-of-hospital cardiac arrest. N Engl J Med 388:299–309. https://doi.org/10.1056/nejmoa2204511

    Article  PubMed  Google Scholar 

  5. Ostadal P, Rokyta R, Karasek J, Kruger A, Vondrakova D, Janotka M et al (2022) Extracorporeal membrane oxygenation in the therapy of cardiogenic shock: results of the ECMO-CS randomized clinical trial. Circulation. https://doi.org/10.1161/circulationaha.122.062949

    Article  PubMed  PubMed Central  Google Scholar 

  6. Scquizzato T, Gamberini L, Zangrillo A, Bonaccorso A, Scandroglio AM, Landoni G (2023) Refractory out-of-hospital cardiac arrest and extracorporeal cardiopulmonary resuscitation: a meta-analysis of randomized trials. Artif Organs. https://doi.org/10.1111/aor.14516

    Article  PubMed  Google Scholar 

  7. Rob D, Smalcova J, Smid O, Kral A, Kovarnik T, Zemanek D et al (2022) Extracorporeal versus conventional cardiopulmonary resuscitation for refractory out-of-hospital cardiac arrest: a secondary analysis of the Prague OHCA trial. Crit Care 26:1–9. https://doi.org/10.1186/s13054-022-04199-3

    Article  Google Scholar 

  8. Belohlavek J, Yannopoulos D, Smalcova J, Rob D, Bartos J, Huptych M et al (2023) Intraarrest transport, extracorporeal cardiopulmonary resuscitation, and early invasive management in refractory out-of-hospital cardiac arrest: an individual patient data pooled analysis of two randomised trials. eClinicalMedicine 59:101988. https://doi.org/10.1016/j.eclinm.2023.101988

    Article  PubMed  PubMed Central  Google Scholar 

  9. Soar J, Böttiger BW, Carli P, Couper K, Deakin CD, Djärv T et al (2021) European Resuscitation Council guidelines 2021: adult advanced life support. Resuscitation. https://doi.org/10.1016/s0025-7753(02)72420-2

    Article  PubMed  PubMed Central  Google Scholar 

  10. Panchal AR, Bartos JA, Cabañas JG, Donnino MW, Drennan IR, Hirsch KG et al (2020) Part 3: adult basic and advanced life support: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. https://doi.org/10.1161/CIR.0000000000000916

    Article  PubMed  PubMed Central  Google Scholar 

  11. Ideker RE, Wolf PD, Alferness C, Krassowska W, Smith WM (1991) Current concepts for selecting the location, size and shape of defibrillation electrodes. Pacing Clin Electrophysiol 14:227–240. https://doi.org/10.1111/j.1540-8159.1991.tb05093.x

    Article  CAS  PubMed  Google Scholar 

  12. Cheskes S, Verbeek PR, Drennan IR, McLeod SL, Turner L, Pinto R et al (2022) Defibrillation strategies for refractory ventricular fibrillation. N Engl J Med. https://doi.org/10.1056/nejmoa2207304

    Article  PubMed  Google Scholar 

  13. Schmidt AS, Lauridsen KG, Adelborg K, Torp P, Bach LF, Jepsen SM et al (2017) Cardioversion efficacy using pulsed biphasic or biphasic truncated exponential waveforms: a randomized clinical trial. J Am Heart Assoc. https://doi.org/10.1161/JAHA.116.004853

    Article  PubMed  PubMed Central  Google Scholar 

  14. Schneider A, Albertsmeier M, Böttiger BW, Teschendorf P (2012) Postreanimationssyndrom. Anaesthesist 61:424–436. https://doi.org/10.1007/s00101-012-2002-8

    Article  CAS  PubMed  Google Scholar 

  15. Adrie C, Laurent I, Monchi M, Cariou A, Dhainaou J‑F, Spaulding C (2004) Postresuscitation disease after cardiac arrest: a sepsis-like syndrome? Curr Opin Crit Care 10:208–212. https://doi.org/10.1097/01.ccx.0000126090.06275.fe

    Article  PubMed  Google Scholar 

  16. Jozwiak M, Bougouin W, Geri G, Grimaldi D, Cariou A (2020) Post-resuscitation shock: recent advances in pathophysiology and treatment. Ann Intensive Care 10:170. https://doi.org/10.1186/s13613-020-00788-z

    Article  PubMed  PubMed Central  Google Scholar 

  17. Sandroni C, Cronberg T, Sekhon M (2021) Brain injury after cardiac arrest: pathophysiology, treatment, and prognosis. Intensive Care Med 47:1393–1414. https://doi.org/10.1007/s00134-021-06548-2

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Sekhon MS, Ainslie PN, Griesdale DE (2017) Clinical pathophysiology of hypoxic ischemic brain injury after cardiac arrest: a “two-hit” model. Crit Care 21:90. https://doi.org/10.1186/s13054-017-1670-9

    Article  PubMed  PubMed Central  Google Scholar 

  19. Lazzarin T, Tonon CR, Martins D, Fávero EL, Baumgratz TD, Pereira FWL et al (2022) Post-cardiac arrest: mechanisms, management, and future perspectives. J Clin Med 12:259. https://doi.org/10.3390/jcm12010259

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Traystman RJ, Kirsch JR, Koehler RC (1991) Oxygen radical mechanisms of brain injury following ischemia and reperfusion. J Appl Physiol 71:1185–1195. https://doi.org/10.1152/jappl.1991.71.4.1185

    Article  CAS  PubMed  Google Scholar 

  21. Nolan JP, Sandroni C, Böttiger BW, Cariou A, Cronberg T, Friberg H et al (2021) European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2021: post-resuscitation care. Resuscitation 161:220–269. https://doi.org/10.1007/s00134-015-4051-3

    Article  PubMed  Google Scholar 

  22. Kilgannon JH (2010) Association between arterial hyperoxia following resuscitation from cardiac arrest and in-hospital mortality. JAMA 303:2165. https://doi.org/10.1001/jama.2010.707

    Article  CAS  PubMed  Google Scholar 

  23. Pilcher J, Weatherall M, Shirtcliffe P, Bellomo R, Young P, Beasley R (2012) The effect of hyperoxia following cardiac arrest—A systematic review and meta-analysis of animal trials. Resuscitation 83:417–422. https://doi.org/10.1016/j.resuscitation.2011.12.021

    Article  PubMed  Google Scholar 

  24. Awad A, Nordberg P, Jonsson M, Hofmann R, Ringh M, Hollenberg J et al (2023) Hyperoxemia after reperfusion in cardiac arrest patients: a potential dose-response association with 30-day survival. Crit Care 27:1–11. https://doi.org/10.1186/s13054-023-04379-9

    Article  Google Scholar 

  25. Bernard SA, Bray JE, Smith K, Stephenson M, Finn J, Grantham H et al (2022) Effect of lower vs higher oxygen saturation targets on survival to hospital discharge among patients resuscitated after out-of-hospital cardiac arrest: the EXACT randomized clinical trial. JAMA 328:1818–1826. https://doi.org/10.1001/jama.2022.17701

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Schmidt H, Kjaergaard J, Hassager C, Mølstrøm S, Grand J, Borregaard B et al (2022) Oxygen targets in comatose survivors of cardiac arrest. N Engl J Med 387:1467–1476. https://doi.org/10.1056/nejmoa2208686

    Article  CAS  PubMed  Google Scholar 

  27. Roberts BW, Kilgannon JH, Trzeciak S (2018) Response by Roberts et al to letters regarding article, “association between early hyperoxia exposure after resuscitation from cardiac arrest and neurological disability: prospective multicenter protocol-directed cohort study. Circulation 138:2864–2865. https://doi.org/10.1161/CIRCULATIONAHA.118.036945

    Article  PubMed  Google Scholar 

  28. Kjaergaard J, Møller JE, Schmidt H, Grand J, Mølstrøm S, Borregaard B et al (2022) Blood-pressure targets in comatose survivors of cardiac arrest. N Engl J Med 387:1456–1466. https://doi.org/10.1056/nejmoa2208687

    Article  PubMed  Google Scholar 

  29. Bougouin W, Slimani K, Renaudier M, Binois Y, Paul M, Dumas F et al (2022) Epinephrine versus norepinephrine in cardiac arrest patients with post-resuscitation shock. Intensive Care Med 48:300–310. https://doi.org/10.1007/s00134-021-06608-7

    Article  CAS  PubMed  Google Scholar 

  30. Ferrari E, Sartre B, Labbaoui M, Heme N, Asarisi F, Redjimi N et al (2022) Diuretics versus volume expansion in the initial management of acute intermediate high-risk pulmonary embolism. Lung 200:179–185. https://doi.org/10.1007/s00408-022-00530-5

    Article  CAS  PubMed  Google Scholar 

  31. Torbicki A, Perrier A, Konstantinides S, Agnelli G, Galiè N, Pruszczyk P et al (2008) Guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 29:2276–2315. https://doi.org/10.1093/eurheartj/ehn310

    Article  CAS  PubMed  Google Scholar 

  32. Konstantinides SV, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Galiè N et al (2014) 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 35:3033–3080. https://doi.org/10.1093/eurheartj/ehu283

    Article  CAS  PubMed  Google Scholar 

  33. Konstantinides SV, Meyer G, Becattini C, Bueno H, Geersing G‑J, Harjola V‑P et al (2019) 2019 ESC guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. https://doi.org/10.1093/eurheartj/ehz405

    Article  PubMed  Google Scholar 

  34. Krüger S, Graf J, Merx MW, Koch KC, Kunz D, Hanrath P et al (2004) Brain natriuretic peptide predicts right heart failure in patients with acute pulmonary embolism. Am Heart J 147:60–65. https://doi.org/10.1016/s0002-8703(03)00528-3

    Article  PubMed  Google Scholar 

  35. Ribeiro A, Juhlin-Dannfelt A, Brodin LA, Holmgren A, Jorfeldt L (1998) Pulmonary embolism: relation between the degree of right ventricle overload and the extent of perfusion defects. Am Heart J 135:868–874. https://doi.org/10.1016/s0002-8703(98)70048-1

    Article  CAS  PubMed  Google Scholar 

  36. O’Reilly DJ, Morrison JJ, Jansen JO, Apodaca AN, Rasmussen TE, Midwinter MJ (2014) Prehospital blood transfusion in the en route management of severe combat trauma: a matched cohort study. J Trauma Acute Care Surg 77:S114–S120. https://doi.org/10.1097/TA.0000000000000328

    Article  PubMed  Google Scholar 

  37. Shackelford SA, Del Junco DJ, Powell-Dunford N, Mazuchowski EL, Howard JT, Kotwal RS et al (2017) Association of prehospital blood product transfusion during medical evacuation of combat casualties in Afghanistan with acute and 30-day survival. JAMA 318:1581–1591. https://doi.org/10.1001/jama.2017.15097

    Article  PubMed  PubMed Central  Google Scholar 

  38. Obermaier M, Schneider NRE (2020) Medical intervention car: Pilotprojekt zur Verbesserung der außerklinischen Notfallversorgung. In: Elsevier emerg, S 18–24

    Google Scholar 

  39. Rudolph M, Sitzmann N, Braun J, Henkel B, Reifferscheid F (2021) Präklinische Therapie mit Blutprodukten – das Projekt „HeliBlut“. Notarzt 37:319–324. https://doi.org/10.1055/a-1546-1374

    Article  Google Scholar 

  40. Kleber C, Giesecke MT, Tsokos M, Haas NP, Buschmann CT (2013) Trauma-related preventable deaths in Berlin 2010: need to change prehospital management strategies and trauma management education. World J Surg 37:1154–1161. https://doi.org/10.1007/s00268-013-1964-2

    Article  CAS  PubMed  Google Scholar 

  41. Rossaint R, Afshari A, Bouillon B, Cerny V, Cimpoesu D, Curry N et al (2023) The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition. Crit Care 27:80. https://doi.org/10.1186/s13054-023-04327-7

    Article  PubMed  PubMed Central  Google Scholar 

  42. Ditzel RMJ, Anderson JL, Eisenhart WJ, Rankin CJ, DeFeo DR, Oak S et al (2020) A review of transfusion- and trauma-induced hypocalcemia: Is it time to change the lethal triad to the lethal diamond? J Trauma Acute Care Surg 88:434–439. https://doi.org/10.1097/TA.0000000000002570

    Article  PubMed  Google Scholar 

  43. Crombie N, Doughty HA, Bishop JRB, Desai A, Dixon EF, Hancox JM et al (2022) Resuscitation with blood products in patients with trauma-related haemorrhagic shock receiving prehospital care (RePHILL): a multicentre, open-label, randomised, controlled, phase 3 trial. Lancet Haematol 9:e250–e261. https://doi.org/10.1016/s2352-3026(22)00040-0

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Katzenschlager S, Obermaier M, Kuhner M, Spöttl W, Dietrich M, Weigand MA et al (2023) Fokus Notfallmedizin 2021/2022 – Zusammenfassung ausgewählter notfallmedizinischer Studien. Anaesthesiologie 72:130–142. https://doi.org/10.1007/s00101-022-01245-1

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Moore HB, Moore EE, Chapman MP, Mcvaney K, Bryskiewicz G, Blechar R et al (2018) Plasma-first resuscitation to treat haemorrhagic shock during emergency ground transportation in an urban area : a randomised trial. Lancet 6736:1–9. https://doi.org/10.1016/S0140-6736(18)31553-8

    Article  Google Scholar 

  46. Sperry JL, Guyette FX, Adams PW (2018) Prehospital plasma during air medical transport in trauma patients. N Engl J Med 379:1783. https://doi.org/10.1056/NEJMc1811315

    Article  PubMed  Google Scholar 

  47. Jost D, Lemoine S, Lemoine F, Derkenne C, Beaume S, Lanoë V et al (2022) Prehospital lyophilized plasma transfusion for trauma-induced coagulopathy in patients at risk for hemorrhagic shock: a randomized clinical trial. JAMA Netw Open 5:E2223619. https://doi.org/10.1001/jamanetworkopen.2022.23619

    Article  PubMed  PubMed Central  Google Scholar 

  48. Coccolini F, Pizzilli G, Corbella D, Sartelli M, Agnoletti V, Agostini V et al (2019) Pre-hospital plasma in haemorrhagic shock management: current opinion and meta-analysis of randomized trials. World J Emerg Surg 14:6. https://doi.org/10.1186/s13017-019-0226-5

    Article  PubMed  PubMed Central  Google Scholar 

  49. Griggs JE, Lyon RM, Sherriff M, Barrett JW, Wareham G, ter Avest E (2022) Predictive clinical utility of pre-hospital point of care lactate for transfusion of blood product in patients with suspected traumatic haemorrhage: derivation of a decision-support tool. Scand J Trauma Resusc Emerg Med 30:1–9. https://doi.org/10.1186/s13049-022-01061-x

    Article  Google Scholar 

  50. Bundesärztekammer (2020) Querschnitts-Leitlinien zur Therapie mit Blutkomponenten und Plasmaderivaten: Gesamtnovelle 2020. Dtsch Ärzteverlag

    Google Scholar 

  51. Deutsche Gesellschaft für Unfallchirurgie. (2023) S3 – Leitlinie Polytrauma / Schwerverletzten-Behandlung. Awmf 2023

    Google Scholar 

  52. Yazer MH, Spinella PC, Bank EA, Cannon JW, Dunbar NM, Holcomb JB et al (2022) THOR-AABB working party recommendations for a prehospital blood product transfusion program. Prehop Emerg Care 26:863–875. https://doi.org/10.1080/10903127.2021.1995089

    Article  Google Scholar 

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Authors and Affiliations

  1. Klinik für Anästhesiologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland

    S. Katzenschlager, M. Obermaier, W. Spöttl, M. Dietrich, M. A. Weigand, F. Weilbacher & E. Popp

  2. Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    M. Kuhner

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Interessenkonflikt

S. Katzenschlager, M. Obermaier, M. Kuhner, W. Spöttl, M. Dietrich, M.A. Weigand, F. Weilbacher und E. Popp geben an, dass kein Interessenkonflikt besteht.

Additional information

Da viele Studien unter Akronymen veröffentlicht und besprochen werden, gibt Tab. 1 einen Überblick über die im vergangenen Jahr erschienenen Studien unter gleichzeitiger Nennung der jeweiligen Akronyme (sofern vorhanden).

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Katzenschlager, S., Obermaier, M., Kuhner, M. et al. Fokus Notfallmedizin 2022/2023 – Zusammenfassung ausgewählter notfallmedizinischer Studien. Anaesthesiologie 72, 809–820 (2023). https://doi.org/10.1007/s00101-023-01330-z

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