Ewy Gordon A
Section of Cardiology, University of Arizona Sarver Heart Center, University of Arizona College of Medicine, Tucson, Arizona, USA.
Curr Opin Cardiol. 2008 Nov;23(6):579-84. doi: 10.1097/HCO.0b013e328310fc65.
To present a new approach to patients with cardiac arrest that improves neurologically normal survival. It is called cardiocerebral resuscitation (CCR), rather than cardiopulmonary resuscitation, as the major goal in cardiac arrest is to resuscitate the heart and the brain. CCR has three components: continuous chest compressions cardiopulmonary resuscitation for bystanders; a different Advanced Cardiac Life Support (ACLS) algorithm for Emergency Medical System; and a recently added aggressive postresuscitation care for resuscitated but comatose patients that includes therapeutic hypothermia and early catheterization/intervention.
Kellum et al. instituted the first two components of CCR in rural Wisconsin in 2004. In the subgroup of patients with a witnessed cardiac arrest and a shockable rhythm they found that neurological intact survival at hospital discharge was 15% the preceding 3 years, when the 2000 Guidelines were being followed, but 40% for the 3 years during CCR. Bobrow et al. instituted CCR for out-of-hospital cardiac arrest in metropolitan areas of Arizona and found a greater than 300% improvement (4.7-17.6%) in survival to hospital discharge of this subgroup of patients.
CCR improves survival of patients with cardiac arrest.
介绍一种针对心脏骤停患者的新方法，以提高神经功能正常的生存率。它被称为心脑复苏（CCR），而非心肺复苏，因为心脏骤停的主要目标是复苏心脏和大脑。CCR有三个组成部分：为旁观者进行持续胸外按压心肺复苏；针对紧急医疗系统的不同高级心血管生命支持（ACLS）算法；以及最近新增的针对复苏后仍昏迷患者的积极复苏后护理，包括治疗性低温和早期导管插入术/干预。
凯卢姆等人于2004年在威斯康星州农村地区实施了CCR的前两个组成部分。在目击心脏骤停且心律可电击复律的患者亚组中，他们发现，在遵循2000年指南的前3年，出院时神经功能完好的生存率为15%，而在CCR实施的3年期间为40%。鲍勃罗等人在亚利桑那州大都市地区对院外心脏骤停实施了CCR，发现该患者亚组的出院生存率提高了300%以上（从4.7%提高到17.6%）。
CCR可提高心脏骤停患者的生存率。
