Memenga Felix, Sinning Christoph
Department of Cardiology, University Heart & Vascular Center Hamburg, 20246 Hamburg, Germany.
J Clin Med. 2024 Jul 7;13(13):3973. doi: 10.3390/jcm13133973.
The morbidity and mortality of out-of-hospital cardiac arrest (OHCA) due to presumed cardiac causes have remained unwaveringly high over the last few decades. Less than 10% of patients survive until hospital discharge. Treatment of OHCA patients has traditionally relied on expert opinions. However, there is growing evidence on managing OHCA patients favorably during the prehospital phase, coronary and intensive care, and even beyond hospital discharge. To improve outcomes in OHCA, experts have proposed the establishment of cardiac arrest centers (CACs) as pivotal elements. CACs are expert facilities that pool resources and staff, provide infrastructure, treatment pathways, and networks to deliver comprehensive and guideline-recommended post-cardiac arrest care, as well as promote research. This review aims to address knowledge gaps in the 2020 consensus on CACs of major European medical associations, considering novel evidence on critical issues in both pre- and in-hospital OHCA management, such as the timing of coronary angiography and the use of extracorporeal cardiopulmonary resuscitation (eCPR). The goal is to harmonize new evidence with the concept of CACs.
在过去几十年中，因推测为心脏原因导致的院外心脏骤停（OHCA）的发病率和死亡率一直居高不下。不到10%的患者能存活至出院。传统上，OHCA患者的治疗依赖专家意见。然而，越来越多的证据表明，在院前阶段、冠状动脉和重症监护期间，甚至出院后，对OHCA患者进行有效管理是可行的。为了改善OHCA的治疗效果，专家们提议设立心脏骤停中心（CAC）作为关键要素。CAC是汇集资源和人员的专业机构，提供基础设施、治疗途径和网络，以提供全面且符合指南推荐的心脏骤停后护理，并促进研究。本综述旨在解决欧洲主要医学协会2020年关于CAC共识中的知识空白，同时考虑院前和院内OHCA管理关键问题的新证据，如冠状动脉造影的时机和体外心肺复苏（eCPR）的使用。目标是使新证据与CAC的概念相协调。
