Pellis Tommaso, Ristagno Giuseppe, Semeraro Federico, Grieco Niccolò, Fabbri Andrea, Balzanelli Mario, Berruto Elisa, Scapigliati Andrea, Sciretti Massimiliano, Cerchiari Erga
Italian Resuscitation Council (IRC).
Italian Resuscitation Council (IRC) - Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO).
G Ital Cardiol (Rome). 2015 Jul-Aug;16(7-8):442-55. doi: 10.1714/1954.21250.
Current evidence on post-resuscitation care suffers from important knowledge gaps on new treatments and prognostication, mainly because of the lack of large multicenter randomized trials. However, optimization of post-resuscitation care is crucial, and the establishment of a treatment easy to be accepted and implemented locally, based on currently available evidence, is advisable. The present article is a multisociety experts' opinion on post-cardiac arrest that aims (i) to provide schematic and clear suggestions on therapeutic interventions to be delivered following resuscitation from cardiac arrest, so as to implement local protocols with a standardized post-resuscitation care; (ii) to suggest post-resuscitation therapeutic interventions that may result in improved survival with good neurological recovery, intended as a Cerebral Performance Category (CPC) score of 1-2; and finally (iii) to propose a pragmatic and schematic approach to post-resuscitation care for rapid initiation of intensive treatments (i.e. temperature management). The suggestions reported in this document are intended for adult patients resuscitated from both out-of-hospital and in-hospital cardiac arrest. They should be considered solely as an experts' opinion aimed to improve post-cardiac arrest care and they do not represent an official national guideline.
目前关于心肺复苏后护理的证据在新治疗方法和预后评估方面存在重大知识空白,主要原因是缺乏大型多中心随机试验。然而,优化心肺复苏后护理至关重要,基于现有证据建立一种易于在当地接受和实施的治疗方法是可取的。本文是多学会专家关于心脏骤停后护理的意见,旨在:(i)为心脏骤停复苏后应采取的治疗干预措施提供简要且清晰的建议,以便实施具有标准化心肺复苏后护理的当地方案;(ii)建议可能提高生存率并伴有良好神经功能恢复(即脑功能分类(CPC)评分为1 - 2)的心肺复苏后治疗干预措施;最后(iii)提出一种实用且简要的心肺复苏后护理方法,以便快速启动强化治疗(即体温管理)。本文件中报告的建议适用于从院外和院内心脏骤停中复苏的成年患者。它们仅应被视为旨在改善心脏骤停后护理的专家意见,并不代表官方国家指南。