Gräsner Jan-Thorsten, Bein Berthold
Anasthesiol Intensivmed Notfallmed Schmerzther. 2016 Mar;51(3):188-95. doi: 10.1055/s-0041-103638. Epub 2016 Mar 29.
Enhanced measures for resuscitation of adults are based on basic measures of resuscitation. The central elements are highly effective chest compressions and avoidance of disruptions that are associated with poor patient outcomes that occur within seconds. The universal algorithm distinguishes the therapy for ventricular fibrillation from the therapy in asystole or pulseless electrical activity (PEA) by the need of defibrillation, and amiodarone administration in the former. Defibrillation is biphasic. In all other aspects, there are no differences in therapy. In each episode of cardiac arrest, reversible causes should be excluded or treated. For the diagnosis during resuscitation, sonography can be helpful. What is new in the 2015 ERC recommendations is the use of capnography, which can be used for the assessment of ROSC (return of spontaneous circulation), ventilation, resuscitation and intubation quality. Mechanical resuscitation devices can be used in selected situations. Successful primary resuscitation should be directly followed by measures of the post-resuscitation care.
成人强化复苏措施基于基本复苏措施。核心要素是进行高效的胸外按压,并避免在数秒内出现与患者不良预后相关的中断情况。通用算法根据是否需要除颤来区分心室颤动的治疗方法与心脏停搏或无脉电活动(PEA)的治疗方法,前者需给予胺碘酮。除颤采用双相波。在其他所有方面,治疗并无差异。在每次心脏骤停发作时,应排除或治疗可逆性病因。在复苏过程中,超声检查有助于诊断。2015年欧洲复苏委员会(ERC)建议中的新内容是使用二氧化碳波形图,其可用于评估自主循环恢复(ROSC)、通气、复苏和插管质量。在特定情况下可使用机械复苏设备。成功的初级复苏后应直接采取复苏后护理措施。