Department of Anaesthesiology, Intensive Care Medicine and Emergency Medicine, Johannes Wesling Klinikum Minden, Ruhr-University Bochum, Minden, Germany.
Department of Anaesthesiology and Intensive Therapy, Jagiellonian University Medical College, Krakow, Poland.
Eur J Trauma Emerg Surg. 2023 Oct;49(5):2031-2046. doi: 10.1007/s00068-023-02271-3.
Cardiac arrest in the operating room is a rare but potentially life-threatening event with mortality rates of more than 50%. Contributing factors are often known, and the event is recognised rapidly as patients are usually under full monitoring. This guideline covers the perioperative period and is complementary to the European Resuscitation Council guidelines.
The European Society of Anaesthesiology and Intensive Care and the European Society for Trauma and Emergency Surgery jointly nominated a panel of experts to develop guidelines for the recognition, treatment, and prevention of cardiac arrest in the perioperative period. A literature search was conducted in MEDLINE, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials. All searches were restricted to publications from 1980 to 2019 inclusive and to the English, French, Italian and Spanish languages. The authors also contributed individual, independent literature searches.
This guideline contains background information and recommendation for the treatment of cardiac arrest in the operating room environment, and addresses controversial topics such as open chest cardiac massage, resuscitative endovascular balloon occlusion and resuscitative thoracotomy, pericardiocentesis, needle decompression, and thoracostomy.
Successful prevention and management of cardiac arrest during anaesthesia and surgery requires anticipation, early recognition, and a clear treatment plan. The ready availability of expert staff and equipment must also be taken into consideration. Success not only depends on medical knowledge, technical skills and a well-organised team using crew resource management, but also on an institutional safety culture embedded in everyday practice through continuous education, training, and multidisciplinary co-operation.
手术室中的心脏骤停是一种罕见但潜在危及生命的事件，死亡率超过 50%。通常可以明确导致该事件的相关因素，且由于患者通常处于全面监测之下，所以能够迅速识别该事件。本指南涵盖围手术期，是对欧洲复苏委员会指南的补充。
欧洲麻醉学会和重症监护医学学会以及欧洲创伤和急诊外科学会共同提名了一个专家小组，制定围手术期心脏骤停的识别、治疗和预防指南。在 MEDLINE、EMBASE、CINAHL 和 Cochrane 对照试验中心注册库中进行了文献检索。所有检索均限于 1980 年至 2019 年期间的出版物，且语言仅限于英语、法语、意大利语和西班牙语。作者还各自进行了独立的文献检索。
本指南包含了在手术室环境中治疗心脏骤停的背景信息和建议，还涉及了开胸心脏按摩、复苏性血管内球囊阻塞和复苏性开胸术、心包穿刺术、针减压和胸腔穿刺术等有争议的话题。
成功预防和管理麻醉和手术期间的心脏骤停需要有预见性、早期识别和明确的治疗计划。还必须考虑到专家人员和设备的随时可用性。成功不仅取决于医学知识、技术技能和组织良好的团队使用机组资源管理，还取决于日常实践中嵌入的机构安全文化，通过持续的教育、培训和多学科合作来实现。
