| Should adrenaline be routinely used by the resuscitation team if a patient suffers a cardiac arrest shortly after cardiac surgery? | |
| | |
MedLine Citation:
|
PMID: 18256115 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether adrenaline might be a useful addition to a protocol for the management of cardiac arrests for patients shortly after cardiac surgery. Altogether 889 papers were found using the reported search, of which 16 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. The quality and level of evidence was assessed using the International Liaison Committee on Resuscitation guideline recommendations. We conclude that the European Resuscitation Council and the American Heart Association both recommend 1 mg of adrenaline as soon as pulseless electrical activity or asystole is identified or after the second failed shock if the rhythm is VF/pulseless VT. However, they acknowledge that the evidence behind this recommendation is lacking and based entirely on animal studies which have as yet not been successfully replicated in human studies to show a benefit of survival to hospital discharge. They acknowledge that the current evidence is insufficient to support or refute the use of adrenaline in arrests and the International Liaison Committee on Resuscitation grade the recommendation to give adrenaline in cardiac arrests as 'indeterminate'. Thus, in the particular situation of a patient who arrests shortly after cardiac surgery where the chance of restoring sinus rhythm either by defibrillation or by an emergency re-sternotomy is high, and where adrenaline could in this situation be highly dangerous once sinus rhythm is restored, we recommend that 1 mg of adrenaline forms no part of the resuscitation protocol for patients who arrest after cardiac surgery. |
| | |
Authors:
|
Myrto Tsagkataki; Adrian Levine; Tim Strang; Joel Dunning |
Related Documents
:
|
19818545 - Ethyl pyruvate enhances intra-resuscitation hemodynamics in prolonged ventricular fibri... 16997785 - Feasibility of basic emergency medical technicians to perform selected advanced life su... 993875 - Toxicology of petroleum naphtha distillate vapors. 7218165 - Post ischemic reperfusion and anoxic perfusion in the isolated heart: alteration in dis... 7850665 - Effects of modified st thomas' hospital solution on coronary artery endothelium depende... 15494385 - Use of erythropoietin in heart failure management. |
Publication Detail:
|
Type: Journal Article; Review Date: 2008-02-06 |
Journal Detail:
|
Title: Interactive cardiovascular and thoracic surgery Volume: 7 ISSN: 1569-9285 ISO Abbreviation: Interact Cardiovasc Thorac Surg Publication Date: 2008 May |
Date Detail:
|
Created Date: 2008-05-22 Completed Date: 2008-07-03 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 101158399 Medline TA: Interact Cardiovasc Thorac Surg Country: England |
Other Details:
|
Languages: eng Pagination: 457-62 Citation Subset: IM |
Affiliation:
|
Department of Cardiothoracic Surgery, James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW, UK. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Animals Benchmarking Cardiac Surgical Procedures / adverse effects* Emergency Medical Services Epinephrine / adverse effects, therapeutic use* Evidence-Based Medicine Heart Arrest / drug therapy*, etiology, surgery Humans Male Patient Care Team* Patient Selection Practice Guidelines as Topic Reoperation Resuscitation / methods* Sternum / surgery Sympathomimetics / adverse effects, therapeutic use* |
| Chemical | |
Reg. No./Substance:
|
0/Sympathomimetics; 51-43-4/Epinephrine |
| Comments/Corrections | |
Comment In:
|
Interact Cardiovasc Thorac Surg. 2008 May;7(3):462-3
[PMID:
18495713
]
Interact Cardiovasc Thorac Surg. 2008 May;7(3):463 [PMID: 18495716 ] Interact Cardiovasc Thorac Surg. 2008 May;7(3):462 [PMID: 18495714 ] Interact Cardiovasc Thorac Surg. 2008 May;7(3):463 [PMID: 18495715 ] Interact Cardiovasc Thorac Surg. 2008 May;7(3):463 [PMID: 18495717 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Increased mutability of Pseudomonas aeruginosa in biofilms.
Next Document: EuroSCORE directed intraaortic balloon pump placement in high-risk patients undergoing cardiac surge...