Simon Weißler, Clemens Kill, Matthias Fischer, Jürgen Knapp, Christian Jung, Peter Kienbaum, Daniel Scheyer, Michael Bernhard
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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.</p>","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Future-oriented further development and approaches to \\\"individualised\\\" cardiopulmonary resuscitation].\",\"authors\":\"Simon Weißler, Clemens Kill, Matthias Fischer, Jürgen Knapp, Christian Jung, Peter Kienbaum, Daniel Scheyer, Michael Bernhard\",\"doi\":\"10.1007/s00063-025-01305-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>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. 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[Future-oriented further development and approaches to "individualised" cardiopulmonary resuscitation].
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.
期刊介绍:
Medizinische Klinik – Intensivmedizin und Notfallmedizin is an internationally respected interdisciplinary journal. It is intended for physicians, nurses, respiratory and physical therapists active in intensive care and accident/emergency units, but also for internists, anesthesiologists, surgeons, neurologists, and pediatricians with special interest in intensive care medicine.
Comprehensive reviews describe the most recent advances in the field of internal medicine with special focus on intensive care problems. Freely submitted original articles present important studies in this discipline and promote scientific exchange, while articles in the category Photo essay feature interesting cases and aim at optimizing diagnostic and therapeutic strategies. In the rubric journal club well-respected experts comment on outstanding international publications. Review articles under the rubric "Continuing Medical Education" present verified results of scientific research and their integration into daily practice. The rubrics "Nursing practice" and "Physical therapy" round out the information.