Switalski J, Lechleuthner A
Institut für Schutz und Rettung (ISR), Feuerwehr Köln, Boltensternstr. 10, 50735, Köln, Deutschland.
Anaesthesiologie. 2025 Sep 18. doi: 10.1007/s00101-025-01593-8.
The term cardiopulmonary resuscitation-induced consciousness (CPRIC) describes the presence of "awareness" or "consciousness" during CPR, i.e. the at least partially conscious (co)experience of one's own resuscitation measures. Depending on the circumstances surrounding the resuscitation, including the medication administered, this may or may not be accompanied by a later memory of the event (= awareness of CPR). In the literature it is unanimously criticized that this is a little-noticed phenomenon and that there are as yet no generally accepted guidelines for dealing with it with or without medication. The problems of recognizing CPRIC based on the possible clinical signs and the importance for patients and personnel are presented. In addition, proposals for action, including analgosedative drug treatment, for the management of CPRIC both during and immediately after CPR are presented: intra-arrest or post-arrest sedation. The case report describes an out-of-hospital CPR with underlying pulseless electrical activity (PEA). During the resuscitation measures, the patient showed clinical signs of consciousness and was analgosedated while resuscitation was ongoing. Nevertheless, he was extubated without complications at the scene of the emergency approximately 5 min after regaining spontaneous circulation, increasingly conscious (Glasgow coma scale, GCS 14) and with stable vital signs.
心肺复苏诱导意识（CPRIC）这一术语描述的是在心肺复苏过程中出现的“意识清醒”或“有意识”状态，即对自身复苏措施至少有部分有意识的（共同）体验。根据复苏时的具体情况，包括所使用的药物，这可能伴有也可能不伴有对该事件的后续记忆（即对心肺复苏的意识）。文献中一致批评这是一个未被充分关注的现象，并且对于无论是否使用药物来处理它，目前尚无普遍接受的指导原则。文中介绍了基于可能的临床体征识别CPRIC的问题以及它对患者和医护人员的重要性。此外，还提出了在心肺复苏期间及复苏后立即处理CPRIC的行动建议，包括使用镇痛镇静药物治疗：复苏期间或复苏后镇静。该病例报告描述了一例院外无脉电活动（PEA）的心肺复苏。在复苏过程中，患者出现了意识的临床体征，并在复苏进行时接受了镇痛镇静。然而，在恢复自主循环后约5分钟，他在急诊现场顺利拔管，意识逐渐恢复（格拉斯哥昏迷量表，GCS 14分），生命体征稳定，且无并发症。
