[面向未来的“个性化”心肺复苏的进一步发展和方法]。

IF 1.5 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Simon Weißler, Clemens Kill, Matthias Fischer, Jürgen Knapp, Christian Jung, Peter Kienbaum, Daniel Scheyer, Michael Bernhard
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引用次数: 0

摘要

复苏研究在提高心脏骤停后的存活率和神经预后方面起着至关重要的作用。这篇综述强调了当前复苏研究的重要方面,并检查了各种治疗方法与现有复苏方案的整合,特别关注个体化复苏。目前的文献在复苏的几个关键主题提出。高质量的胸部按压是心肺复苏(CPR)的核心质量特征。在心肺复苏术中,血管造影是量化血流动力学的有效工具。舒张压(DBP)似乎是一个优于潮末二氧化碳的参数,因为它更准确地反映冠状动脉灌注。舒张压(DBP)的目标值应为bbb25 mmHg,因为它与提高生存率和更好的神经预后相关。持续给药肾上腺素和液体可以增加舒张压,提高自然循环恢复的机会。此外,超声,特别是经食管超声心动图,可以帮助确定胸部按压的最佳按压点,从而提高心肺复苏术的有效性。脉搏检查不是检测心脏骤停或自然循环恢复的最佳选择,而且会延长“无血流”时间。一个明显更好的选择可能是使用超声波进行脉搏检查。如果常规复苏失败,可以考虑体外心肺复苏术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[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.

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来源期刊
CiteScore
2.60
自引率
9.10%
发文量
93
审稿时长
6-12 weeks
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.
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