Weißler Simon, Kill Clemens, Fischer Matthias, Knapp Jürgen, Jung Christian, Kienbaum Peter, Scheyer Daniel, Bernhard Michael
Zentrale Notaufnahme, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität, Moorenstraße 5, 40225, Düsseldorf, Deutschland.
Zentrum für Notfallmedizin, Universitätsmedizin Essen, Essen, Deutschland.
Med Klin Intensivmed Notfmed. 2025 Aug 4. doi: 10.1007/s00063-025-01305-5.
Resuscitation research plays a crucial role in improving survival rates and neurological outcomes following cardiac arrest. This review highlights essential aspects of current resuscitation research and examines the integration of various treatment approaches into existing resuscitation protocols, with a particular focus on individualized resuscitation. The current literature on several key topics in resuscitation is presented. High-quality chest compressions are a central quality feature of cardiopulmonary resuscitation (CPR). Capnography is a proven tool for quantifying hemodynamics during CPR. Diastolic blood pressure (DBP) appears to be a superior parameter compared to end-tidal carbon dioxide, as it reflects coronary perfusion more precisely. Target values for diastolic blood pressure (DBP) should >25 mmHg, as they correlate with improved survival rates and better neurological outcomes. Continuous administration of adrenaline and fluids can increase DBP and improve the chances of return of spontaneous circulation. Additionally, ultrasound, particularly transesophageal echocardiography, can help identify the optimal compression point for chest compressions, thereby increasing CPR effectiveness. Pulse checks are not optimally suited for detecting cardiac arrest or return of spontaneous circulation and prolong the "no-flow" time. A significantly better alternative may be the use of ultrasound for pulse checks. If conventional resuscitation fails, extracorporeal CPR can be considered.
复苏研究在提高心脏骤停后的生存率和神经功能结局方面起着至关重要的作用。本综述强调了当前复苏研究的重要方面，并探讨了将各种治疗方法整合到现有复苏方案中的情况，特别关注个体化复苏。本文介绍了当前关于复苏几个关键主题的文献。高质量的胸外按压是心肺复苏（CPR）的核心质量特征。二氧化碳波形图是一种在CPR期间量化血流动力学的经过验证的工具。与呼气末二氧化碳相比，舒张压（DBP）似乎是一个更优的参数，因为它能更精确地反映冠状动脉灌注。舒张压（DBP）的目标值应>25 mmHg，因为它们与更高的生存率和更好的神经功能结局相关。持续给予肾上腺素和液体可提高DBP并增加自主循环恢复的机会。此外，超声，尤其是经食管超声心动图，可帮助确定胸外按压的最佳按压点，从而提高CPR的有效性。脉搏检查不太适合用于检测心脏骤停或自主循环恢复，并且会延长“无血流”时间。一个明显更好的替代方法可能是使用超声进行脉搏检查。如果传统复苏失败，可以考虑体外CPR。
