| Current concepts in cardiopulmonary resuscitation in adults. | |
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MedLine Citation:
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PMID: 10643188 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Cardiopulmonary resuscitation (CPR) provides artificial circulation and ventilation during cardiopulmonary arrest. CPR is further categorised as basic life support (BLS), advanced cardiac life support (ACLS) and postresuscitation support. BLS consists of provision of a patent upper airway, ventilation and circulation of blood by closed chest cardiac compressions. ACLS includes use of specialised equipment to maintain the airway, early defibrillation and pharmacologic therapy. Successful outcome from an arrest depends on the total duration of an arrest and early defibrillation, as ventricular fibrillation is the most common cardiac rhythm found in adult cardiac arrest. Initial drug therapy during CPR aims at correction of arterial hypoxaemia and restoring coronary and cerebral perfusion. Oxygen and epinephrine constitute the mainstay of drug therapy during CPR. In patients with ventricular tachycardia, lidocaine is the drug of choice, followed by bretylium. Magnesium has proved to be useful in both refractory pulseless ventricular tachycardia and fibrillation. Atropine has not been demonstrated to improve outcome from arrest but can be administered in bradyasystolic cardiac arrest. The routine administration of bicarbonate and calcium is no longer recommended but situations exist where they can be used appropriately. Administration of drugs during CPR should preferably be via a central route, but epinephrine, lidocaine and atropine can be administered via the endotracheal tube if intravenous access has not been established. Postresuscitation care includes mechanical ventilation if necessary to optimise oxygenation and ventilation and steps to maintain vital organ and optimal brain protection, which includes avoidance of hypertension, hypotension and hyperglycaemia. |
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Authors:
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S Datta; N F Nasr; A Khorasani; R Datta |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Journal of the Indian Medical Association Volume: 97 ISSN: 0019-5847 ISO Abbreviation: J Indian Med Assoc Publication Date: 1999 Jul |
Date Detail:
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Created Date: 2000-02-10 Completed Date: 2000-02-10 Revised Date: 2005-11-16 |
Medline Journal Info:
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Nlm Unique ID: 7505608 Medline TA: J Indian Med Assoc Country: INDIA |
Other Details:
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Languages: eng Pagination: 259-64, 270 Citation Subset: IM |
Affiliation:
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Department of Anaesthesiology and Pain Management, Cook County Hospital, Chicago, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Cardiopulmonary Resuscitation / methods*, trends Female Heart Arrest / therapy* Humans Intensive Care / methods*, trends Pregnancy Pregnancy Complications, Cardiovascular / therapy |
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