Νεότερα δεδομένα για την Καρδιοπνευμονική Αναζωογόνηση

[Πατρωνάκης Μάνος]

 Νεότερα δεδομένα για την Καρδιοπνευμονική Αναζωογόνηση με βάση τις κατευθυντήριες οδηγίες, στην βασική και προχωρημένη ΚΑΡΠΑ σε ενήλικες,
και στην Παιδιατρική ΚΑΡΠΑ, όπως δημοσιεύθηκε στο περιοδικό της Ελληνικής Καρδιολογικής Εταρείας (τεύχος Φεβρουαρίου ΄09).
 Ευχαριστώ τον συγγραφέα Καρδιολόγο κ. Θανάση Παπαθανασίου για την ευγενικά συναδελφική διάθεση.

[Argirios Argiriou]

Επίσημη σελίδα, στα Σουηδικά δυστυχώς, με ότι νεότερο για την  Καρδιοπνευμονική Αναζωογόνηση (HLR)

Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος

[Argirios Argiriou]

Journal Watch

February 6, 2025

In-Hospital Cardiac Arrest: Terminating Resuscitation
Daniel D. Dressler, MD, MSc, MHM, FACP, reviewing Holmberg MJ et al. JAMA Intern Med 2025 Jan 27 Richman IB et al. JAMA Intern Med 2025 Jan 27

A rule using four readily available clinical characteristics can lead to reasonable termination of resuscitation when prognosis is poor.

Guidelines offer little guidance regarding criteria for terminating resuscitation efforts during an in-hospital cardiac arrest. In this study, Scandinavian investigators used data from ≈10,000 patients with in-hospital arrests (≈20% of whom were in intensive care units) to derive termination-of-resuscitation rules that could identify at least 10% of patients who would qualify for early termination of resuscitation and also assure that <1% of patients who would qualify actually would survive at 30 days. These rules were validated on data from 14,000 additional patients.

Using hundreds of rapidly accessible patient characteristics, investigators identified four characteristics — unmonitored status (i.e., not on telemetry), unwitnessed arrest, initial asystole rhythm, and ≥10-minute duration of resuscitation — that were predictors for nonsurvival of resuscitation when all characteristics were present (0.5% survival at 30 days). Using this rule, 12% of patients met all criteria to terminate resuscitation early.

Comment

In the U.S., median time of resuscitation for patients who do not achieve return of spontaneous circulation is 20 minutes. Clinicians might use these four characteristics to decide to terminate resuscitation after 10 minutes, as survival likelihood is very low when all criteria are met. Having such a rule at our disposal could help clinicians feel comfortable with terminating resuscitative efforts when prognosis is poor. Validation of these rules in other populations would help confirm their generalizability.

Citations

Holmberg MJ et al. Termination of resuscitation rules for in-hospital cardiac arrest. JAMA Intern Med 2025 Jan 27; [e-pub]. (Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος)

Richman IB et al. Decision rules for termination of resuscitation — A roadmap for challenging terrain. JAMA Intern Med 2025 Jan 27; [e-pub]. (Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος)

Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος