Document Detail


Update on advanced life support and resuscitation techniques.
MedLine Citation:
PMID:  15596952     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: This article is a review of the most recent findings in resuscitation techniques in advanced cardiac life support. The article focuses particularly on the period after July 1, 2003, but relevant new findings before this period are also included. RECENT FINDINGS: Randomized clinical trial results suggest that the current cardiopulmonary resuscitation and advanced cardiac life support guidelines may need to be modified. Early defibrillation during the electrical phase of cardiac arrest remains the most crucial intervention, but performing cardiopulmonary resuscitation before defibrillation may be more effective, as compared with immediate defibrillation, during the circulatory phase of cardiac arrest. Biphasic waveforms are superior to monophasic damped sine waveforms in achieving defibrillation. Novel cardiopulmonary resuscitation methods that increase negative intrathoracic pressure promote an increase in blood flow return to the heart. These devices have been correlated with improved short-term survival rates during the circulatory phase of cardiac arrest. Vasopressin administration, given alone or in combination with epinephrine, should be considered during the circulatory phase of out-of-hospital cardiac arrest, particularly in patients presenting with asystole as the initial rhythm. Induction of hypothermia during the metabolic phase in cardiac arrest survivors improves 6-month survival rates and neurologic outcomes. SUMMARY: Strategies to improve the low survival outcomes of cardiac arrest victims are available. Clinical trials testing these strategies suggest benefit from certain interventions but are not definitive. These different therapeutic interventions should be performed in a phase-specific-oriented fashion according to the three-phase time-sensitive model of cardiac arrest.
Authors:
Mauricio F Hong; Paul Dorian
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in cardiology     Volume:  20     ISSN:  0268-4705     ISO Abbreviation:  Curr. Opin. Cardiol.     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2004-12-14     Completed Date:  2005-09-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8608087     Medline TA:  Curr Opin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1-6     Citation Subset:  IM    
Affiliation:
Department of Medicine, Division of Cardiology, University of Toronto, Toronto, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Amiodarone / therapeutic use
Anti-Arrhythmia Agents / therapeutic use
Cardiopulmonary Resuscitation / trends*
Clinical Trials as Topic
Electric Countershock
Emergency Medical Services / trends
Epinephrine / therapeutic use
Heart Arrest / therapy*
Humans
Hypothermia, Induced
Life Support Care / trends*
Practice Guidelines as Topic
Time Factors
Vasoconstrictor Agents / therapeutic use
Vasopressins / therapeutic use
Ventricular Fibrillation / drug therapy
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 0/Vasoconstrictor Agents; 11000-17-2/Vasopressins; 1951-25-3/Amiodarone; 51-43-4/Epinephrine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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