| Introduction to Wolf Creek IV Conference. | |
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MedLine Citation:
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PMID: 9153038 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Early milestones of resuscitation research culminated in the 1950s in the documentation of modern external cardiovascular resuscitation (CPR) steps "ABC," followed by advanced and prolonged life support. Implementation of guidelines has been suboptimal. Self-training of the public in life-supporting first aid, including CPR-ABC-available since the 1970s-is only now being re-evaluated and hopefully implemented. Standard external CPR potency is inadequate for reliably restoring spontaneous circulation and saving the brain after prolonged arrests or in patients with sick hearts. Ultra-advanced life-support methods such as open-chest CPR and emergency cardiopulmonary bypass should be tried for bridging standard external CPR-resistant hearts to recovery or repair. Outcome studies in large animals can be fully controlled, in contrast to randomized clinical outcome trials, which have limitations. The HIV paranoia must not lead to abandoning the teaching of steps A and B, which are essential for any kind of coma, asphyxial arrest, and prolonged ventricular fibrillation arrest. Sternal compressions alone can produce some ventilation in animals, but not reliably in comatose humans. For cerebral resuscitation after cardiac arrest, the outcome benefit of the hypertensive bout, other cerebral blood flow-promoting measures, and mild resuscitative hypothermia have been documented in outcome models of large animals and are ready for clinical feasibility trials. The Wolf Creek CPR researchers' conferences I, II, and III were meant to advise the guidelines-setting committees of the American Heart Association and other agencies. The ten topics of Wolf Creek IV, published in this issue of New Horizons, were different in design and objective. There was an appropriate emphasis on fully automatic external defibrillation by lay rescuers, which has the potential for a breakthrough effect. Wolf Creek V, which we recommend to be conducted around the turn of the millennium, should focus on the pathophysiology and therapeutics of respiratory, cardiac, and cerebral resuscitation in general, and on organ, cellular, and molecular level research into how cells, organs, and organisms die, and how acute dying processes might be reversed. What to teach whom and how should be left to guideline conferences of agencies. |
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Authors:
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P Safar |
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Publication Detail:
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Type: Historical Article; Journal Article |
Journal Detail:
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Title: New horizons (Baltimore, Md.) Volume: 5 ISSN: 1063-7389 ISO Abbreviation: New Horiz Publication Date: 1997 May |
Date Detail:
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Created Date: 1997-07-17 Completed Date: 1997-07-17 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9416195 Medline TA: New Horiz Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 97-105 Citation Subset: IM; Q; X |
Affiliation:
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University of Pittsburgh Medical Center, PA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Cardiopulmonary Resuscitation / history*, instrumentation, trends Congresses as Topic / history History, 20th Century Humans Research / history, trends |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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