体外心肺复苏治疗院外心脏骤停

4区 医学 Q3 Medicine
Anaesthesist Pub Date : 2022-05-01 Epub Date: 2021-10-25 DOI:10.1007/s00101-021-01056-w
Christopher Gaisendrees, Sebastian Walter, Anton Sabashnikov, Christoph Adler, Thorsten Wahlers
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引用次数: 1

摘要

背景:院外心脏骤停(OHCA)每年在德国影响约75,000人,并与预后有限和高死亡率相关。使用动静脉体外膜氧合(av-ECMO)系统的体外心肺复苏(eCPR)是一种额外的治疗选择,它越来越广泛,自2020年以来被纳入指南算法。方法:在PubMed和Embase中选择性检索文献,重点研究eCPR对OHCA的影响。并对目前正在开展的临床研究进行了总结。结果:关于eCPR对OHCA的益处的现有数据主要基于回顾性队列研究。与常规复苏(CPR)相比,采用eCPR治疗的患者的生存优势和神经预后方面的优势可以从这些数据中得出。目前的两项随机对照研究证实了这一效应。目前正在进行的研究正在调查尽早在患者OHCA部位进行院外ECMO插管是否与更好的生存率相关。结论:尽管目前缺乏数据,但必须假设eCPR治疗在选定的OHCA患者中具有生存优势。如果这可以被其他高质量的研究证实,似乎有必要评估资源密集型eCPR计划是否可以全面建立以及在多大程度上可以全面建立。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Extracorporeal cardiopulmonary resuscitation for treatment of out-of-hospital cardiac arrest].

Background: Out-of-hospital cardiac arrest (OHCA) affects ca. 75,000 people each year in Germany and is associated with a limited prognosis and a high mortality. Extracorporeal cardiopulmonary resuscitation (eCPR) using arteriovenous extracorporeal membrane oxygenation (av-ECMO) systems is an additional option for treatment, which is increasingly more widespread and since 2020 anchored in the guideline algorithm.

Methods: A selective search of the literature was carried out in PubMed and Embase focusing on studies that investigated eCPR for OHCA. Furthermore, clinical studies on this topic that are currently recruiting and running are summarized.

Results: The available data on the benefits of eCPR for OHCA are mostly based on retrospective cohort studies. A survival advantage and an advantage in the neurological outcome could be derived from these data for selected patients treated with eCPR vs. conventionally resuscitated patients (CPR). This effect could be confirmed by two current randomized controlled studies. Studies which are currently running are investigating if out-of-hospital ECMO cannulation at the earliest time possible at the site of OHCA of patients could be associated with a better survival.

Conclusion: Despite a current scarcity of data, a survival advantage for eCPR treatment in selected OHCA patients must be assumed. If this can be substantiated by other high-quality studies, it seems to be indicated to evaluate if and to what extent resource-intensive eCPR programs can be comprehensively established.

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来源期刊
Anaesthesist
Anaesthesist 医学-麻醉学
CiteScore
1.60
自引率
0.00%
发文量
55
审稿时长
4-8 weeks
期刊介绍: Der Anaesthesist is an internationally recognized journal de­aling with all aspects of anaesthesia and intensive medicine up to pain therapy. Der Anaesthesist addresses all specialists and scientists particularly interested in anaesthesiology and it is neighbouring areas. Review articles provide an overview on selected topics reflecting the multidisciplinary environment including pharmacotherapy, intensive medicine, emergency medicine, regional anaesthetics, pain therapy and medical law. Freely submitted original papers allow the presentation of relevant clinical studies and serve the scientific exchange. Case reports feature interesting cases and aim at optimizing diagnostic and therapeutic strategies. Review articles under the rubric ''Continuing Medical Education'' present verified results of scientific research and their integration into daily practice.
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