School of Clinical Sciences, University of Bristol, Bristol, UK.
Anaesthesia and Intensive Care Medicine, Royal United Hospital, Bath, UK.
Intensive Care Med. 2017 Sep;43(9):1282-1293. doi: 10.1007/s00134-017-4739-7. Epub 2017 Mar 11.
Over the last 15 years, treatment of comatose post-cardiac arrest patients has evolved to include therapeutic strategies such as urgent coronary angiography with percutaneous coronary intervention (PCI), targeted temperature management (TTM)-requiring mechanical ventilation and sedation-and more sophisticated and cautious prognostication. In 2015, collaboration between the European Resuscitation Council (ERC) and the European Society for Intensive Care Medicine (ESICM) resulted in the first European guidelines on post-resuscitation care. This review addresses the major recent advances in the treatment of cardiac arrest, recent trials that have challenged current practice and the remaining areas of uncertainty.
在过去的 15 年中,昏迷后心脏骤停患者的治疗方法已经发展到包括紧急冠状动脉造影和经皮冠状动脉介入治疗(PCI)、需要机械通气和镇静的目标温度管理(TTM)以及更复杂和谨慎的预后判断等治疗策略。2015 年,欧洲复苏委员会(ERC)和欧洲重症监护医学学会(ESICM)之间的合作制定了第一份关于复苏后护理的欧洲指南。本文回顾了心脏骤停治疗方面的主要最新进展、挑战当前实践的最新试验以及仍然存在的不确定性领域。