Abstract
The new CPR guidelines are based on a scientific consensus which was reached by 281 international experts. Chest compressions (100/min, 4–5 cm deep) should be performed in a ratio of 30:2 with ventilation (tidal volume 500 ml, Ti 1 s, FIO2 if possible 1.0). After a single defibrillation attempt (initially biphasic 150–200 J, monophasic 360 J, subsequently with the respective highest energy), chest compressions are initiated again immediately for 2 min. Endotracheal intubation is the gold standard; other airway devices may be employed as well depending on individual skills. Drug administration routes for adults and children: first choice IV, second choice intraosseous, third choice endobronchial [epinephrine dose 2–3× (adults) or 10× (pediatric patients) higher than IV]. Vasopressors: 1 mg epinephrine every 3–5 min IV. After the third unsuccessful defibrillation attempt amiodarone IV (300 mg); repetition (150 mg) possible. Sodium bicarbonate (1 ml/kg 8.4%) only in excessive hyperkalemia, metabolic acidosis, or intoxication with tricyclic antidepressants. Consider atropine (3 mg) and aminophylline (5 mg/kg). Thrombolysis during spontaneous circulation only in myocardial infarction or massive pulmonary embolism; during CPR only during massive pulmonary embolism. Cardiopulmonary bypass only after cardiac surgery, hypothermia or intoxication. Pediatrics: best improvement in outcome by preventing cardiocirculatory collapse. Alternate chest thumps and chest compression (infants), or abdominal compressions (>1-year-old) in foreign body airway obstruction. Initially five breaths, followed by chest compressions (100/min; ~1/3 of chest diameter): ventilation ratio 15:2. Treatment of potentially reversible causes (4 “Hs”, “HITS”: hypoxia, hypovolemia, hypo- and hyperkaliemia, hypothermia, cardiac tamponade, intoxication, thrombo-embolism, tension pneumothorax). Epinephrine 10 µg/kg IV or intraosseously, or 100 µg (endobronchially) every 3–5 min. Defibrillation (4 J/kg; monophasic oder biphasic) followed by 2 min CPR, then ECG and pulse check. Newborns: inflate the lungs with bag-valve mask ventilation. If heart rate <60/min chest compressions:ventilation ratio 3:1 (120 chest compressions/min). Postresuscitation phase: initiate mild hypothermia [32–34°C for 12–24 h; slow rewarming (<0.5°C/h)]. Prediction of CPR outcome is not possible at the scene; determining neurological outcome within 72 h after cardiac arrest with evoked potentials, biochemical tests and physical examination. Even during low suspicion for an acute coronary syndrome, record a prehospital 12-lead ECG. In parallel to pain therapy, aspirin (160–325 mg PO or IV) and in addition clopidogrel (300 mg PO). As antithrombin, heparin (60 IU/kg, max. 4000 IU) or enoxaparine. In ST-segment elevation myocardial infarction, define reperfusion strategy depending on duration of symptoms until PCI (prevent delay >90 min until PCI). Stroke is an emergency and needs to be treated in a stroke unit. A CT scan is the most important evaluation, MRT may replace a CT scan. After hemorrhage exclusion, thrombolysis within 3 h of symptom onset (0.9 mg/kg rt-PA IV; max 90 mg within 60 min, 10% of the entire dosage as initial bolus, no aspirin, no heparin within the first 24 h). In severe hemorrhagic shock, definite control of bleeding is the most important goal. For successful CPR of trauma patients, a minimal intravascular volume status and management of hypoxia are essential. Aggressive fluid resuscitation, hyperventilation, and excessive ventilation pressure may impair outcome in severe hemorrhagic shock. Despite bad prognosis, CPR in trauma patients may be successful in select cases. Any CPR training is better than nothing; simplification of contents and processes remains important.
Similar content being viewed by others
Literatur
(2005) 2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 112: IV1–203
(2005) 2005 International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Part 7: Neonatal resuscitation. Resuscitation 67: 293–303
(1998) Indications for ACE inhibitors in the early treatment of acute myocardial infarction: systematic overview of individual data from 100,000 patients in randomized trials. ACE Inhibitor Myocardial Infarction Collaborative Group. Circulation 97: 2202–2212
(1997) The International Stroke Trial (IST): a randomised trial of aspirin, subcutaneous heparin, both, or neither among 19435 patients with acute ischaemic stroke. International Stroke Trial Collaborative Group. Lancet 349: 1569–1581
(2002) Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 346: 549–556
(2000) Organised inpatient (stroke unit) care for stroke. Stroke Unit Trialists‘ Collaboration. Cochrane Database Syst Rev: CD000197
(2005) Part 7.5: Postresuscitation support. Circulation 112: IV84–88
(2006) Primary versus tenecteplase-facilitated percutaneous coronary intervention in patients with ST-segment elevation acute myocardial infarction (ASSENT-4 PCI): randomised trial. Lancet 367: 569–578
(1988) Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. Lancet 2: 349–360
(1996) A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). CAPRIE Steering Committee. Lancet 348: 1329–1339
(2000) Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The Acute Respiratory Distress Syndrome Network. N Engl J Med 342: 1301–1308
Abella BS, Alvarado JP, Myklebust H et al. (2005) Quality of cardiopulmonary resuscitation during in-hospital cardiac arrest. JAMA 293: 305–310
Abu-Laban RB, McIntyre CM, Christenson JM et al. (2006) Aminophylline in bradyasystolic cardiac arrest: a randomised placebo-controlled trial. Lancet 367: 1577–1584
Adrie C, Laurent I, Monchi M et al. (2004) Postresuscitation disease after cardiac arrest: a sepsis-like syndrome? Curr Opin Crit Care 10: 208–212
Ames A 3rd, Wright RL, Kowada M et al. (1968) Cerebral ischemia. II. The no-reflow phenomenon. Am J Pathol 52: 437–453
Anonymous (2000) Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care. Resuscitation 46: 1–447
Anthi A, Tzelepis GE, Alivizatos P et al. (1998) Unexpected cardiac arrest after cardiac surgery: incidence, predisposing causes, and outcome of open chest cardiopulmonary resuscitation. Chest 113: 15–19
Antman EM, Morrow DA, McCabe CH et al. (2006) Enoxaparin versus unfractionated heparin with fibrinolysis for ST-elevation myocardial infarction. N Engl J Med 354: 1477–1488
Arntz HR, Agrawal R, Richter H et al. (2001) Phased chest and abdominal compression-decompression versus conventional cardiopulmonary resuscitation in out-of-hospital cardiac arrest. Circulation 104: 768–772
Aufderheide TP, Lurie KG (2004) Death by hyperventilation: a common and life-threatening problem during cardiopulmonary resuscitation. Crit Care Med 32: S345–351
Aung K, Htay T (2005) Vasopressin for cardiac arrest: a systematic review and meta-analysis. Arch Intern Med 165: 17–24
Baraka A, Ayoub C, Kawkabani N (2000) Magnesium therapy for refractory ventricular fibrillation. J Cardiothorac Vasc Anesth 14: 196–199
Barbash IM, Freimark D, Gottlieb S et al. (2002) Outcome of myocardial infarction in patients treated with aspirin is enhanced by pre-hospital administration. Cardiology 98: 141–147
Bar-Joseph G, Abramson NS, Kelsey SF et al. (2005) Improved resuscitation outcome in emergency medical systems with increased usage of sodium bicarbonate during cardiopulmonary resuscitation. Acta Anaesthesiol Scand 49: 6–15
Beck DH, McQuillan P, Smith GB (2002) Waiting for the break of dawn? The effects of discharge time, discharge TISS scores and discharge facility on hospital mortality after intensive care. Intensive Care Med 28: 1287–1293
Bernard S, Buist M, Monteiro O, Smith K (2003) Induced hypothermia using large volume, ice-cold intravenous fluid in comatose survivors of out-of-hospital cardiac arrest: a preliminary report. Resuscitation 56: 9–13
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
Boersma E, Harrington RA, Moliterno DJ et al. (2002) Platelet glycoprotein IIb/IIIa inhibitors in acute coronary syndromes: a meta-analysis of all major randomised clinical trials. Lancet 359: 189–198
Böttiger BW, Bode C, Kern S et al. (2001) Efficacy and safety of thrombolytic therapy after initially unsuccessful cardiopulmonary resuscitation: a prospective clinical trial. Lancet 357: 1583–1585
Boyd R (2000) Witnessed resuscitation by relatives. Resuscitation 43: 171–176
Brown CG, Martin DR, Pepe PE et al. (1992) A comparison of standard-dose and high-dose epinephrine in cardiac arrest outside the hospital. The Multicenter High-Dose Epinephrine Study Group. N Engl J Med 327: 1051–1055
Buckman RF Jr, Badellino MM, Mauro LH et al. (1995) Direct cardiac massage without major thoracotomy: feasibility and systemic blood flow. Resuscitation 29: 237–248
Bunch TJ, White RD, Gersh BJ et al. (2003) Long-term outcomes of out-of-hospital cardiac arrest after successful early defibrillation. N Engl J Med 348: 2626–2633
Callaham M, Madsen CD, Barton CW et al. (1992) A randomized clinical trial of high-dose epinephrine and norepinephrine vs standard-dose epinephrine in prehospital cardiac arrest. JAMA 268: 2667–2672
Celenza T, Gennat HC, O’Brien D et al. (2002) Community competence in cardiopulmonary resuscitation. Resuscitation 55: 157–165
Chen ZM, Jiang LX, Chen YP et al. (2005) Addition of clopidogrel to aspirin in 45,852 patients with acute myocardial infarction: randomised placebo-controlled trial. Lancet 366: 1607–1621
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
Coats TJ, Keogh S, Clark H, Neal M (2001) Prehospital resuscitative thoracotomy for cardiac arrest after penetrating trauma: rationale and case series. J Trauma 50: 670–673
Davis PG, Tan A, O’Donnell CP, Schulze A (2004) Resuscitation of newborn infants with 100% oxygen or air: a systematic review and meta-analysis. Lancet 364: 1329–1333
Ditchey RV, Lindenfeld J (1988) Failure of epinephrine to improve the balance between myocardial oxygen supply and demand during closed-chest resuscitation in dogs. Circulation 78: 382–389
Donnelly P, Assar D, Lester C (2000) A comparison of manikin CPR performance by lay persons trained in three variations of basic life support guidelines. Resuscitation 45: 195–199
Dorian P, Cass D, Schwartz B et al. (2002) Amiodarone as compared with lidocaine for shock-resistant ventricular fibrillation. N Engl J Med 346: 884–890
Dracup K, Moser DK, Doering LV et al. (2000) A controlled trial of cardiopulmonary resuscitation training for ethnically diverse parents of infants at high risk for cardiopulmonary arrest. Crit Care Med 28: 3289–3295
Dybvik T, Strand T, Steen PA (1995) Buffer therapy during out-of-hospital cardiopulmonary resuscitation. Resuscitation 29: 89–95
Eftestol T, Losert H, Kramer-Johansen J et al. (2005) Independent evaluation of a defibrillation outcome predictor for out-of-hospital cardiac arrested patients. Resuscitation 67: 55–61
Emerman CL, Pinchak AC, Hancock D, Hagen JF (1988) Effect of injection site on circulation times during cardiac arrest. Crit Care Med 16: 1138–1141
Engdahl J, Bang A, Lindqvist J, Herlitz J (2000) Can we define patients with no and those with some chance of survival when found in asystole out of hospital? Am J Cardiol 86: 610–614
Fearing NM, Harrison PB (2002) Complications of the Heimlich maneuver: case report and literature review. J Trauma 53: 978–979
Ferguson JJ, Califf RM, Antman EM et al. (2004) Enoxaparin vs unfractionated heparin in high-risk patients with non-ST-segment elevation acute coronary syndromes managed with an intended early invasive strategy: primary results of the SYNERGY randomized trial. JAMA 292: 45–54
Fiebach JB, Schellinger PD, Gass A et al. (2004) Stroke magnetic resonance imaging is accurate in hyperacute intracerebral hemorrhage: a multicenter study on the validity of stroke imaging. Stroke 35: 502–506
Fischer M, Böttiger BW, Popov-Cenic S, Hossmann KA (1996) Thrombolysis using plasminogen activator and heparin reduces cerebral no-reflow after resuscitation from cardiac arrest: an experimental study in the cat. Intensive Care Med 22: 1214–1223
Fischer M, Hossmann KA (1995) No-reflow after cardiac arrest. Intensive Care Med 21: 132–141
Födisch M, Fischer M (2004) Preclinical induction of therapeutic hypothermia in out-of-hospital cardiac arrest. Resuscitation 62: 341
Gabrielli A, Wenzel V, Layon AJ et al. (2005) Lower esophageal sphincter pressure measurement during cardiac arrest in humans: potential implications for ventilation of the unprotected airway. Anesthesiology 103: 897–899
Gao JM, Gao YH, Wei GB et al. (2004) Penetrating cardiac wounds: principles for surgical management. World J Surg 28: 1025–1029
Gausche M, Lewis RJ, Stratton SJ et al. (2000) Effect of out-of-hospital pediatric endotracheal intubation on survival and neurological outcome: a controlled clinical trial. JAMA 283: 783–790
Gershlick AH, Stephens-Lloyd A, Hughes S et al. (2005) Rescue angioplasty after failed thrombolytic therapy for acute myocardial infarction. N Engl J Med 353: 2758–2768
Gilbert M, Busund R, Skagseth A et al. (2000) Resuscitation from accidental hypothermia of 13.7 degrees C with circulatory arrest. Lancet 355: 375–376
Ginsberg MD, Sternau LL, Globus MY et al. (1992) Therapeutic modulation of brain temperature: relevance to ischemic brain injury. Cerebrovasc Brain Metab Rev 4: 189–225
Gluckman PD, Wyatt JS, Azzopardi D et al. (2005) Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: multicentre randomised trial. Lancet 365: 663–670
Gottlieb R (1897) Über die Wirkung der Nebennierenextrakte auf Herz und Blutdruck. Arch Exp Pathol Pharmacol 38: 99–112
Gray WA (1993) Prehospital resuscitation. The good, the bad, and the futile. JAMA 270: 1471–1472
Gray WA, Capone RJ, Most AS (1991) Unsuccessful emergency medical resuscitation – Are continued efforts in the emergency department justified? N Engl J Med 325: 1393–1398
Gries A, Zink W, Bernhard M et al. (2005) Einsatzrealität im Notarztdienst. Notfall Rettungsmed 8: 391–398
Hachimi-Idrissi S, Corne L, Ebinger G et al. (2001) Mild hypothermia induced by a helmet device: a clinical feasibility study. Resuscitation 51: 275–281
Hacke W, Albers G, Al-Rawi Y et al. (2005) The Desmoteplase in Acute Ischemic Stroke Trial et al. (DIAS): a phase II MRI-based 9-hour window acute stroke thrombolysis trial with intravenous desmoteplase. Stroke 36: 66–73
Hacke W, Donnan G, Fieschi C et al. (2004) Association of outcome with early stroke treatment: pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trials. Lancet 363: 768–774
Hacke W, Kaste M, Olsen TS et al. (2001) Empfehlungen der Europäischen Schlaganfallinitiative zur Versorgung und Behandlung des Schlaganfalls. Nervenarzt 72: 807–819
Haddad B, Mercer BM, Livingston JC et al. (2000) Outcome after successful resuscitation of babies born with apgar scores of 0 at both 1 and 5 minutes. Am J Obstet Gynecol 182: 1210–1214
Halkin A, Grines CL, Cox DA et al. (2004) Impact of intravenous β-blockade before primary angioplasty on survival in patients undergoing mechanical reperfusion therapy for acute myocardial infarction. J Am Coll Cardiol 43: 1780–1787
Hallstrom A, Cobb L, Johnson E, Copass M (2000) Cardiopulmonary resuscitation by chest compression alone or with mouth-to-mouth ventilation. N Engl J Med 342: 1546–1553
Hallstrom A, Rea TD, Sayre MR et al. (2006) Manual chest compression vs use of an automated chest compression device during resuscitation following out-of-hospital cardiac arrest: a randomized trial. JAMA 295: 2620–2628
Hallstrom AP, Ornato JP, Weisfeldt M et al. (2004) Public-access defibrillation and survival after out-of-hospital cardiac arrest. N Engl J Med 351: 637–646
Halperin HR, Tsitlik JE, Gelfand M et al. (1993) A preliminary study of cardiopulmonary resuscitation by circumferential compression of the chest with use of a pneumatic vest. N Engl J Med 329: 762–768
Handley AJ (2002) Teaching hand placement for chest compression – A simpler technique. Resuscitation 53: 29–36
Heimlich HJ (1981) Subdiaphragmatic pressure to expel water from the lungs of drowning persons. Ann Emerg Med 10: 476–480
Hochman JS, Sleeper LA, Webb JG et al. (1999) Early revascularization in acute myocardial infarction complicated by cardiogenic shock. SHOCK Investigators. Should we emergently revascularize occluded coronaries for cardiogenic shock? N Engl J Med 341: 625–634
Hochman JS, Sleeper LA, White HD et al. (2001) One-year survival following early revascularization for cardiogenic shock. JAMA 285: 190–192
Hodgetts TJ, Kenward G, Vlackonikolis I et al. (2002) Incidence, location and reasons for avoidable in-hospital cardiac arrest in a district general hospital. Resuscitation 54: 115–123
Hopson LR, Hirsh E, Delgado J et al. (2003) Guidelines for withholding or termination of resuscitation in prehospital traumatic cardiopulmonary arrest: joint position statement of the National Association of EMS Physicians and the American College of Surgeons Committee on Trauma. J Am Coll Surg 196: 106–112
Hossmann KA (2001) Neuronale Apoptose. Ein neuer Weg zur Therapie der zerebralen Ischamie? Anaesthesist 50: 903–904
Hossmann KA (1997) Reperfusion of the brain after global ischemia: hemodynamic disturbances. Shock 8: 95–101; discussion 102–103
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
Jones JH, Murphy MP, Dickson RL et al. (2004) Emergency physician-verified out-of-hospital intubation: miss rates by paramedics. Acad Emerg Med 11: 707–709
Katz SH, Falk JL (2001) Misplaced endotracheal tubes by paramedics in an urban emergency medical services system. Ann Emerg Med 37: 32–37
Kause J, Smith G, Prytherch D et al. (2004) A comparison of antecedents to cardiac arrests, deaths and emergency intensive care admissions in Australia and New Zealand, and the United Kingdom – The ACADEMIA study. Resuscitation 62: 275–282
Keeley EC, Boura JA, Grines CL (2006) Comparison of primary and facilitated percutaneous coronary interventions for ST-elevation myocardial infarction: quantitative review of randomised trials. Lancet 367: 579–588
Keeley EC, Boura JA, Grines CL (2003) Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials. Lancet 361: 13–20
Kellermann AL, Staves DR, Hackman BB (1988) In-hospital resuscitation following unsuccessful prehospital advanced cardiac life support: ‚heroic efforts‘ or an exercise in futility? Ann Emerg Med 17: 589–594
Kette F, Reffo I, Giordani G et al. (2005) The use of laryngeal tube by nurses in out-of-hospital emergencies: preliminary experience. Resuscitation 66: 21–25
Kokkinis K (1994) The use of the laryngeal mask airway in CPR. Resuscitation 27: 9–12
Konig B, Benger J, Goldsworthy L (2005) Automatic external defibrillation in a 6-year-old. Arch Dis Child 90: 310–311
Krep H, Brinker G, Pillekamp F, Hossmann K (2000) Treatment with an endothelin type A receptor-antagonist after cardiac arrest and resuscitation improves cerebral hemodynamic and functional recovery in rats. Crit Care Med 28: 2866–2872
Krep H, Brinker G, Schwindt W, Hossmann KA (2000) Endothelin type A-antagonist improves long-term neurological recovery after cardiac arrest in rats. Crit Care Med 28: 2873–2880
Krismer AC, Wenzel V, Lindner KH et al. (2005) Influence of positive end-expiratory pressure ventilation on survival during severe hemorrhagic shock. Ann Emerg Med 46: 337–342
Krismer AC, Wenzel V, Voelckel WG et al. (2005) Employing vasopressin as an adjunct vasopressor in uncontrolled traumatic hemorrhagic shock. Three cases and a brief analysis of the literature. Anaesthesist 54: 220–224
Kudenchuk PJ, Cobb LA, Copass MK et al. (1999) Amiodarone for resuscitation after out-of-hospital cardiac arrest due to ventricular fibrillation. N Engl J Med 341: 871–878
Kwan I, Bunn F, Roberts I (2003) Timing and volume of fluid administration for patients with bleeding. Cochrane Database Syst Rev: CD002245
Lafuente-Lafuente C, Melero-Bascones M (2004) Active chest compression-decompression for cardiopulmonary resuscitation. Cochrane Database Syst Rev: CD002751
Langhelle A, Sunde K, Wik L, Steen PA (2000) Airway pressure with chest compressions versus Heimlich manoeuvre in recently dead adults with complete airway obstruction. Resuscitation 44: 105–108
Lefrancois DP, Dufour DG (2002) Use of the esophageal tracheal combitube by basic emergency medical technicians. Resuscitation 52: 77–83
Lenclen R, Mazraani M, Jugie M et al. (2002) Use of a polyethylene bag: a way to improve the thermal environment of the premature newborn at the delivery room. Arch Pediatr 9: 238–244
Lerner EB, Billittier AJ, Shah MN et al. (2003) A comparison of first-responder automated external defibrillator (AED) application rates and characteristics of AED training. Prehosp Emerg Care 7: 453–457
Lurie KG, Voelckel WG, Zielinski T et al. (2001) Improving standard cardiopulmonary resuscitation with an inspiratory impedance threshold valve in a porcine model of cardiac arrest. Anesth Analg 93: 649–655
Madl C, Holzer M (2004) Brain function after resuscitation from cardiac arrest. Curr Opin Crit Care 10: 213–217
Mann K, Berg RA, Nadkarni V (2002) Beneficial effects of vasopressin in prolonged pediatric cardiac arrest: a case series. Resuscitation 52: 149–156
Maron BJ, Estes NA 3rd, Links MS (2005) Task Force 11: Commotio cordis. J Am Coll Cardiol 45: 1371–1373
Martin GB, Rivers EP, Paradis NA et al. (1998) Emergency department cardiopulmonary bypass in the treatment of human cardiac arrest. Chest 113: 743–751
Morrison LJ, Verbeek PR, McDonald AC et al. (2000) Mortality and prehospital thrombolysis for acute myocardial infarction: a meta-analysis. JAMA 283: 2686–2692
Moser B, Voelckel W, Gardetto A et al. (2005) One night in a snowbank: a case report of severe hypothermia and cardiac arrest. Resuscitation 65: 365–368
Mullner M, Sterz F, Binder M et al. (1996) Arterial blood pressure after human cardiac arrest and neurological recovery. Stroke 27: 59–62
Negovsky VA, Gurvitch AM (1995) Post-resuscitation disease – A new nosological entity. Its reality and significance. Resuscitation 30: 23–27
Nolan JP, Deakin CD, Soar J et al. (2005) European Resuscitation Council Guidelines for Resuscitation 2005 Section 4. Adult advanced life support. Resuscitation 67 [Suppl 1]: S39–86
Nolan JP, Morley PT, Hoek TL, Hickey RW (2003) Therapeutic hypothermia after cardiac arrest. An advisory statement by the Advancement Life Support Task Force of the International Liaison Committee on Resuscitation. Resuscitation 57: 231–235
Ong ME, Ornato JP, Edwards DP et al. (2006) Use of an automated, load-distributing band chest compression device for out-of-hospital cardiac arrest resuscitation. JAMA 295: 2629–2637
Padosch SA, Motsch J, Böttiger BW (2002) Thrombolyse während der kardiopulmonalen Reanimation. Anaesthesist 51: 516–532
Palme-Kilander C (1992) Methods of resuscitation in low-Apgar-score newborn infants – A national survey. Acta Paediatr 81: 739–744
Pepe PE, Zachariah BS, Chandra NC (1993) Invasive airway techniques in resuscitation. Ann Emerg Med 22: 393–403
Perondi MB, Reis AG, Paiva EF et al. (2004) A comparison of high-dose and standard-dose epinephrine in children with cardiac arrest. N Engl J Med 350: 1722–1730
Plaisance P, Lurie KG, Vicaut E et al. (2004) Evaluation of an impedance threshold device in patients receiving active compression-decompression cardiopulmonary resuscitation for out of hospital cardiac arrest. Resuscitation 61: 265–271
Pottle A, Bullock I, Thomas J, Scott L (2002) Survival to discharge following open chest cardiac compression (OCCC). A 4-year retrospective audit in a cardiothoracic specialist centre – Royal Brompton and Harefield NHS Trust, United Kingdom. Resuscitation 52: 269–272
Rabitsch W, Schellongowski P, Staudinger T et al. (2003) Comparison of a conventional tracheal airway with the Combitube in an urban emergency medical services system run by physicians. Resuscitation 57: 27–32
Redding JS (1979) The choking controversy: critique of evidence on the Heimlich maneuver. Crit Care Med 7: 475–479
Rivers E, Nguyen B, Havstad S et al. (2001) Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 345: 1368–1377
Rozenberg A, Incagnoli P, Delpech P et al. (2001) Prehospital use of minimally invasive direct cardiac massage (MID-CM): a pilot study. Resuscitation 50: 257–262
Sabatine MS, Cannon CP, Gibson CM et al. (2005) Addition of clopidogrel to aspirin and fibrinolytic therapy for myocardial infarction with ST-segment elevation. N Engl J Med 352: 1179–1189
Sack JB, Kesselbrenner MB (1994) Hemodynamics, survival benefits, and complications of interposed abdominal compression during cardiopulmonary resuscitation. Acad Emerg Med 1: 490–497
Sack JB, Kesselbrenner MB, Bregman D (1992) Survival from in-hospital cardiac arrest with interposed abdominal counterpulsation during cardiopulmonary resuscitation. JAMA 267: 379–385
Safar P, Behringer W, Böttiger BW, Sterz F (2002) Cerebral resuscitation potentials for cardiac arrest. Crit Care Med 30: S140–144
Sanders AB, Ewy GA (2005) Cardiopulmonary resuscitation in the real world: when will the guidelines get the message? JAMA 293: 363–365
Sanders AB, Kern KB, Berg RA et al. (2002) Survival and neurologic outcome after cardiopulmonary resuscitation with four different chest compression-ventilation ratios. Ann Emerg Med 40: 553–562
Schneider T, Martens PR, Paschen H et al. (2000) Multicenter, randomized, controlled trial of 150-J biphasic shocks compared with 200- to 360-J monophasic shocks in the resuscitation of out-of-hospital cardiac arrest victims. Optimized Response to Cardiac Arrest (ORCA) Investigators. Circulation 102: 1780–1787
Schwartz AC (1985) Neurological recovery after cardiac arrest: clinical feasibility trial of calcium blockers. Am J Emerg Med 3: 1–10
Sellick BA (1961) Cricoid pressure to control regurgitation of stomach contents during induction of anaesthesia. Lancet 2: 404–406
Simoons ML (2001) Effect of glycoprotein IIb/IIIa receptor blocker abciximab on outcome in patients with acute coronary syndromes without early coronary revascularisation: the GUSTO IV-ACS randomised trial. Lancet 357: 1915–1924
Spohr F, Arntz HR, Bluhmki E et al. (2005) International multicentre trial protocol to assess the efficacy and safety of tenecteplase during cardiopulmonary resuscitation in patients with out-of-hospital cardiac arrest: the Thrombolysis in Cardiac Arrest (TROICA) Study. Eur J Clin Invest 35: 315–323
Steen PA (2005) Post-hoc analysis of sodium bicarbonate use or EMS systems? A caveat in resuscitation research. Acta Anaesthesiol Scand 49: 1–3
Steen S, Liao Q, Pierre L et al. (2002) Evaluation of LUCAS, a new device for automatic mechanical compression and active decompression resuscitation. Resuscitation 55: 285–299
Steen S, Sjoberg T, Olsson P, Young M (2005) Treatment of out-of-hospital cardiac arrest with LUCAS, a new device for automatic mechanical compression and active decompression resuscitation. Resuscitation 67: 25–30
Steg PG, Bonnefoy E, Chabaud S et al. (2003) Impact of time to treatment on mortality after prehospital fibrinolysis or primary angioplasty: data from the CAPTIM randomized clinical trial. Circulation 108: 2851–2856
Stiell IG, Hebert PC, Weitzman BN et al. (1992) High-dose epinephrine in adult cardiac arrest. N Engl J Med 327: 1045–1050
Stiell IG, Hebert PC, Wells GA et al. (2001) Vasopressin versus epinephrine for inhospital cardiac arrest: a randomised controlled trial. Lancet 358: 105–109
Stiell IG, Wells GA, Field B et al. (2004) Advanced cardiac life support in out-of-hospital cardiac arrest. N Engl J Med 351: 647–656
Swenson RD, Weaver WD, Niskanen RA et al. (1988) Hemodynamics in humans during conventional and experimental methods of cardiopulmonary resuscitation. Circulation 78: 630–639
Takino M, Okada Y (1993) The optimum timing of resuscitative thoracotomy for non-traumatic out-of-hospital cardiac arrest. Resuscitation 26: 69–74
Thel MC, Armstrong AL, McNulty SE et al. (1997) Randomised trial of magnesium in in-hospital cardiac arrest. Duke Internal Medicine Housestaff. Lancet 350: 1272–1276
Tucker KJ, Idris A (1994) Clinical and laboratory investigations of active compression-decompression cardiopulmonary resuscitation. Resuscitation 28: 1–7
Turner I, Turner S (2004) Optimum cardiopulmonary resuscitation for basic and advanced life support: a simulation study. Resuscitation 62: 209–217
Van den Berghe G, Wouters P, Weekers F et al. (2001) Intensive insulin therapy in critically ill patients. N Engl J Med 345: 1359–1367
Van’t Hof AW, Ernst N, Boer MJ de et al. (2004) Facilitation of primary coronary angioplasty by early start of a glycoprotein 2b/3a inhibitor: results of the ongoing Tirofiban in Myocardial Infarction Evaluation et al. (On-TIME) trial. Eur Heart J 25: 837–846
Virkkunen I, Yli-Hankala A, Silfvast T (2004) Induction of therapeutic hypothermia after cardiac arrest in prehospital patients using ice-cold Ringer’s solution: a pilot study. Resuscitation 62: 299–302
Von Goedecke A, 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
Von Goedecke A, Keller C, Voelckel WG et al. (2006) Maskenbeatmung als Rückzugsstrategie zur endotrachealen Intubation. Anaesthesist 55: 70–79
Von Goedecke A, Wagner-Berger HG, Stadlbauer KH et al. (2004) Effects of decreasing peak flow rate on stomach inflation during bag-valve-mask ventilation. Resuscitation 63: 131–136
Von Goedecke A, Wenzel V (2004) „Oben mit bitte“! Die Beatmung während der kardiopulmonalen Reanimation. Anaesthesist 53: 925–926
Wagner-Berger HG, Wenzel V, Voelckel WG et al. (2003) A pilot study to evaluate the SMART BAG: a new pressure-responsive, gas-flow limiting bag-valve-mask device. Anesth Analg 97: 1686–1689
Wallentin L, Goldstein P, Armstrong PW et al. (2003) Efficacy and safety of tenecteplase in combination with the low-molecular-weight heparin enoxaparin or unfractionated heparin in the prehospital setting: the assessment of the safety and efficacy of a new thrombolytic regimen (ASSENT)-3 PLUS randomized trial in acute myocardial infarction. Circulation 108: 135–142
Ward KR, Sullivan RJ, Zelenak RR, Summer WR (1989) A comparison of interposed abdominal compression CPR and standard CPR by monitoring end-tidal PCO2. Ann Emerg Med 18: 831–837
Wenzel V, Idris AH, Banner MJ et al. (1998) Influence of tidal volume on the distribution of gas between the lungs and stomach in the nonintubated patient receiving positive-pressure ventilation. Crit Care Med 26: 364–368
Wenzel V, Krismer AC, Arntz HR et al. (2004) A comparison of vasopressin and epinephrine for out-of-hospital cardiopulmonary resuscitation. N Engl J Med 350: 105–113
Wenzel V, Krismer AC, Voelckel WG et al. (2002) Der Einsatz von Arginin Vasopressin bei der kardiopulmonalen Reanimation. Eine Analyse der experimentellen und klinischen Erfahrungen sowie ein Ausblick in die Zukunft. Anaesthesist 51: 191–202
Wenzel V, Lindner KH, Prengel AW, Strohmenger HU (2000) Effect of phased chest and abdominal compression-decompression cardiopulmonary resuscitation on myocardial and cerebral blood flow in pigs. Crit Care Med 28: 1107–1112
Wenzel V, Prengel AW, Lindner KH (2000) A strategy to improve endobronchial drug administration. Anesth Analg 91: 255–256
Wenzel V, Voelckel WG, Krismer AC et al. (2001) Die neuen internationalen Richtlinien zur kardiopulmonalen Reanimation. Eine Analyse und Kommentierung der wichtigsten Änderungen. Anaesthesist 50: 342–357
Widimsky P, Budesinsky T, Vorac D et al. (2003) Long distance transport for primary angioplasty vs immediate thrombolysis in acute myocardial infarction. Final results of the randomized national multicentre trial – PRAGUE-2. Eur Heart J 24: 94–104
Wik L, Kramer-Johansen J, Myklebust H et al. (2005) Quality of cardiopulmonary resuscitation during out-of-hospital cardiac arrest. JAMA 293: 299–304
Wolcke BB, Mauer DK, Schoefmann MF et al. (2003) 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. Circulation 108: 2201–2205
Working Group, Ad Hoc Subcommittee on Outcomes, American College of Surgeons-Committee on Trauma (2001) Practice management guidelines for emergency department thoracotomy. J Am Coll Surg 193: 303–309
Young KD, Seidel JS (1999) Pediatric cardiopulmonary resuscitation: a collective review. Ann Emerg Med 33: 195–205
Yusuf S, Zhao F, Mehta SR et al. (2001) Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med 345: 494–502
Zandbergen EG, Haan RJ de, Stoutenbeek CP et al. (1998) Systematic review of early prediction of poor outcome in anoxic-ischaemic coma. Lancet 352: 1808–1812
Interessenkonflikt
Es besteht kein Interessenkonflikt. Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen. Die Präsentation des Themas ist unabhängig und die Darstellung der Inhalte produktneutral.
Author information
Authors and Affiliations
Corresponding author
Additional information
Alle Autoren waren Delegierte des European Resuscitation Council in der internationalen Arbeitsgruppe zur Neuerstellung der Reanimationsleitlinien. Weiterhin sind in zusätzlichen Funktionen: B.W. Böttiger Chairman des European Resuscitation Council, M.A. Baubin Delegierter des Austrian Resuscitation Council, B. Dirks Delegierter der deutschen Mitglieder des European Resuscitation Council, J. Bahr Schatzmeister des European Resuscitation Council und H.R. Arntz Chairman der Acute Coronary Syndromes working group des European Resuscitation Council.
Rights and permissions
About this article
Cite this article
Wenzel, V., Russo, S., Arntz, H.R. et al. Die neuen Reanimationsleitlinien 2005 des European Resuscitation Council. Anaesthesist 55, 958–979 (2006). https://doi.org/10.1007/s00101-006-1064-x
Issue Date:
DOI: https://doi.org/10.1007/s00101-006-1064-x