Michaelis Patrick, Leone Richard J
Patrick Michaelis is a private consultant in Bellingham, Washington.
Richard Leone is a cardiothoracic surgeon, Skagit Regional Health, Mount Vernon, and Kadlec Regional Medical Center, Richland, Washington.
Crit Care Nurse. 2019 Feb;39(1):15-25. doi: 10.4037/ccn2019309.
More than 250 000 cardiac surgical procedures are performed annually in the United States. Postoperative cardiac arrest rates range from 0.7% to 5.2%. This article reviews current evidence for cardiac arrest resuscitation after cardiac surgery. The evaluation included resuscitation guidelines and 22 studies identified through a MEDLINE search. Evidence-based resuscitation differs from advanced cardiovascular life support guidelines. European Resuscitation Council guidelines include correcting reversible causes of arrest, applying defibrillation/pacing before external cardiopulmonary resuscitation, resternotomy within 5 minutes if electrical therapies fail, and restricting epinephrine use to avoid rebound hypertension. A 2017 Society of Thoracic Surgeons protocol derived from European Resuscitation Council guidelines is now standard of care in the United States. Evidence-based practices can improve survival and reduce resternotomy rates. This article describes the clinical implementation of the Society of Thoracic Surgeons guidelines.
在美国，每年进行超过25万例心脏外科手术。术后心脏骤停发生率在0.7%至5.2%之间。本文回顾了心脏手术后心脏骤停复苏的当前证据。评估包括复苏指南以及通过医学文献数据库检索确定的22项研究。循证复苏不同于高级心血管生命支持指南。欧洲复苏委员会指南包括纠正可逆转的心脏骤停原因、在进行体外心肺复苏之前进行除颤/起搏、如果电疗法失败则在5分钟内进行再次开胸手术，以及限制使用肾上腺素以避免反弹性高血压。2017年美国胸外科医师协会源自欧洲复苏委员会指南的方案现已成为美国的护理标准。循证实践可以提高生存率并降低再次开胸手术率。本文描述了美国胸外科医师协会指南的临床实施情况。
