From the Columbia University, New York, New York.
Shaare Zedek Medical Center, Jerusalem, Israel.
Anesth Analg. 2018 Mar;126(3):876-888. doi: 10.1213/ANE.0000000000002596.
Cardiac arrest in the operating room and procedural areas has a different spectrum of causes (ie, hypovolemia, gas embolism, and hyperkalemia), and rapid and appropriate evaluation and management of these causes require modification of traditional cardiac arrest algorithms. There is a small but growing body of literature describing the incidence, causes, treatments, and outcomes of circulatory crisis and perioperative cardiac arrest. These events are almost always witnessed, frequently known, and involve rescuer providers with knowledge of the patient and their procedure. In this setting, there can be formulation of a differential diagnosis and a directed intervention that treats the likely underlying cause(s) of the crisis while concurrently managing the crisis itself. Management of cardiac arrest of the perioperative patient is predicated on expert opinion, physiologic rationale, and an understanding of the context in which these events occur. Resuscitation algorithms should consider the evaluation and management of these causes of crisis in the perioperative setting.
手术室和手术区域的心脏骤停具有不同的病因谱（即低血容量、气体栓塞和高钾血症），需要对这些病因进行快速和适当的评估和管理，这就需要对传统的心脏骤停算法进行修改。有一小部分但不断增长的文献描述了循环危机和围手术期心脏骤停的发生率、病因、治疗和结果。这些事件几乎总是有目击者，通常是众所周知的，涉及到了解患者及其手术的抢救提供者。在这种情况下，可以制定鉴别诊断，并进行有针对性的干预，以治疗危机的潜在根本原因，同时同时管理危机本身。围手术期患者心脏骤停的管理基于专家意见、生理原理以及对这些事件发生背景的理解。复苏算法应考虑在围手术期环境中评估和管理这些危机的病因。
