Anest. intenziv. Med. 2011;22(2):115-123
Summary of the most important changes in the Guidelines for cardiopulmonary resuscitationResuscitation - Review Article
- 1 Klinika anesteziologie, resuscitace a intenzivní medicíny, Univerzita Karlova v Praze, Lékařská fakulta v Hradci Králové, Fakultní nemocnice Hradec Králové
- 2 Zdravotnická záchranná služba Královéhradeckého kraje, Hradec Králové
- 3 Anesteziologicko-resuscitační klinika, Univerzita Karlova v Praze, Lékařská fakulta v Plzni, Fakultní nemocnice Plzeň
- 4 Department of Anesthesia, Dalhousie University, Halifax, Nova Scotia, Canada
About 500,000 people suffer a sudden cardiac arrest in Europe every year but their treatment has not been satisfactory for years. The main issues in the Guidelines for cardiopulmonary resuscitation launched by the European Resuscitation Council in October 2010 are summarized in the article. The changes in the new recommendations are based on recent scientific evidence in resuscitation medicine and an effort to make them simpler compared to the last 2005 Guidelines. Chest compression remains the most important action in both basic and advanced life support. The victim's chest must be pushed hard into the depth of at least 5 centimetres with a frequency of at least 100 per minute. Higher employment of automated external defibrillators and better availability of devices to deliver early defibrillation are encouraged. Some steps in the advanced life support algorithm have also changed. Neither tracheal administration of drugs nor atropine in asystole have been recommended, a treatment of the post-cardiac arrest syndrome has been emphasized, and the adverse effects of hyperoxia have been proven. Chest compressions, early defibrillation, and early therapeutic hypothermia are the key procedures of cardiopulmonary resuscitation affecting favourable outcome.
Keywords: cardiopulmonary resuscitation; resuscitation; basic life support; advanced life support; guidelines; treatment; European Resuscitation Council
Received: January 5, 2011; Accepted: February 3, 2011; Published: April 1, 2011 Show citation
References
- European Resuscitation Council 100,000 lives can be saved per year in Europe. The new ERC Guidelines on resuscitation [online]. 2010-10-18 [cit. 2011-01-05]. Dostupné na www: http://www.cprguidelines.eu/2010/press.php
- Nolan, J. P., Soar, J., Zideman, D. A., Biarent, D., Bossaert, L. L., Deakin, C., Koster, R. W., Wyllie, J., Böttiger, B., on behalf of the European Resuscitation Council Guidelines Writing Group. European Resuscitation Council Guidelines for Resuscitation 2010. Section 1. Executive summary. Resuscitation, 2010, 81, p. 1219-1276.
Go to original source...
Go to PubMed...
- Černý, V., Matějovič, M., Dostál, P. Doporučené postupy a jejich význam. In Černý, V., Matějovič, M., Dostál, P. et al. Vybrané doporučené postupy v intenzivní medicíně. Praha: Maxdorf, 2009, s. 11-15.
- Truhlář, A. Horké novinky v kardiopulmonální resuscitaci: Guidelines 2010. In Jiránek, P. (ed.) VI. anesteziologické dny Vysočiny. Jihlava: EKON, 2010, p. 25-29.
- Truhlář, A., Mathauser, R. Přehled aktuálních změn v doporučených postupech pro neodkladnou resuscitaci. In Procházka, M., Ježek, B., Vaněk, J., Antoš, K. (ed.) Sborník příspěvků 7. ročníku konference Medicína katastrof, Hradec Králové, 25.-26. listopad 2010. Hradec Králové: Zdravotní a sociální akademie, 2010, s. 94-100.
- Kreutziger, J., Wenzel, V. Overcoming frustration about neutral clinical studies in cardiopulmonary resuscitation. Resuscitation, 2009, 80, p. 723-725.
Go to original source...
Go to PubMed...
- Nolan, J. P., Soar, J., Zideman, D. A., Biarent, D., Bossaert, L. L., Deakin, C., Koster, R. W., Wyllie, J., Böttiger, B., on behalf of the European Resuscitation Council Guidelines Writing Group Summary of the main changes in the Resuscitation Guidelines [online]. 2010-10-18 [cit. 2011-01-05]. Dostupné na www: http://www.cprguidelines.eu/2010/summary.php
- Pell, J. P., Sirel, J. M., Marsden, A. K. et al. Presentation, management, and outcome of out of hospital cardiopulmonary arrest: comparison by underlying aetiology. Heart, 2003, 89, p 839-842.
Go to original source...
Go to PubMed...
- Hazinski, M. F., Chameides, L., Hemphill, R., Samson, R. A., Schexnayder, S. M., Sinz, E. Highlights of the 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Dallas: American Heart Association, 2010, 28 p.
- Roppolo, L. P., Pepe, P. E., Bobrow, B. J. The Role of Gasping in Resuscitation. In Vincent, J. L. (ed.). Yearbook of Intensive Care and Emergency Medicine 2010. Berlin, Heidelberg: Springer-Verlag, 2010, p. 83-95.
Go to original source...
- Kouwenhoven, W. B., Jude, J. R., Knickerbocker, G. G. Closed-chest cardiac massage. JAMA, 1960, 173, s. 1064-1067.
Go to original source...
Go to PubMed...
- Handley, A. J. Compression-only CPR - To teach or not to teach? Resuscitation, 2009, 80, p. 752-754.
Go to original source...
Go to PubMed...
- Nolan, J. P. Push, blow or both: is there a role for compression-only CPR? Anaesthesia, 2010, 65, p. 771-774.
Go to original source...
Go to PubMed...
- Yeung, J., Soar, J., Perkins, G. D. Feedback to Improve the Quality of CPR. In Vincent, J. L. (ed.). Yearbook of Intensive Care and Emergency Medicine 2009. Berlin Heidelberg: Springer-Verlag, 2009, p. 555-564.
Go to original source...
- International Liaison Committee on Resuscitation AED safety sign [online]. 2008-06-03 [cit. 2011-01-05]. Dostupné na www: http://www.ilcor.org/data/letter-ILCOR-AED-sign.pdf
- Truhlář, A. Doporučení ILCOR pro označení automatizovaných externích defibrilátorů (AED). Vnitř. Lék., 2010, 56, s. 434-438.
- Valenzuela, T. D., Roe, D. J., Nichol, G. et al. Outcomes of rapid defibrillation by security officers after cardiac arrest in casinos. N. Engl. J. Med., 2000, 343, p. 1206-1209.
Go to original source...
Go to PubMed...
- Simpson, P. M., Goodger, M. S., Bendall, J. C. Delayed versus immediate defibrillation for out-of-hospital cardiac arrest due to ventricular fibrillation: A systematic review and meta-analysis of randomised controlled trials. Resuscitation, 2010, 81, p. 925-931.
Go to original source...
Go to PubMed...
- Nolan, J. P., Soar, J. Airway and Ventilation during CPR In Vincent, J. L. (ed.). Yearbook of Intensive Care and Emergency Medicine 2010. Berlin, Heidelberg: Springer-Verlag, 2010, p. 75-82.
Go to original source...
- Kilgannon, J. H., Jones, A. E., Shapiro, N. I., Angelos, M. G., Milcarek, B., Hunter, K., Parrillo, J. E., Trzeciak, S., Emergency Medicine Shock Research Network (EMShockNet) Investigators. Association between arterial hyperoxia following resuscitation from cardiac arrest and in-hospital mortality. JAMA, 2010, 303, p. 2165-2171.
Go to original source...
Go to PubMed...
- Brücken, A., Kaab, A. B., Kottmann, K., Rossaint, R., Nolte, K. W., Weis, J., Fries, M. Reducing the duration of 100% oxygen ventilation in the early reperfusion period after cardiopulmonary resuscitation decreases striatal brain damage. Resuscitation, 2010, 81, p. 1698-1703.
Go to original source...
Go to PubMed...
- Nolan, J. P., Neumar, R. W., Adrie, C. et al. Post-cardiac arrest syndrome: epidemiology, pathophysiology, treatment, and prognostication. A Scientific Statement from the International Liaison Committee on Resuscitation; the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; the Council on Stroke. Resuscitation, 2008, 79, p. 350-379.
Go to original source...
Go to PubMed...
- Nolan, J. P., Neumar, R. W. The Post-Cardiac Arrest Syndrome. In Vincent, J. L. (ed.). Yearbook of Intensive Care and Emergency Medicine 2009. Berlin, Heidelberg : Springer-Verlag, 2009, p. 565-574.
Go to original source...
- Truhlář, A. Syndrom po srdeční zástavě. In Černý, V., Matějovič, M., Dostál, P. et al. Vybrané doporučené postupy v intenzivní medicíně. Praha: Maxdorf, 2009, s. 219-228.