Cardiopulmonary Resuscitation Science Research Articles

ОСОБЕННОСТИ ПРОВЕДЕНИЯ РЕАНИМАЦИОННЫХ МЕРОПРИЯТИЙ И ИНТЕНСИВНОЙ ТЕРАПИИ ПРИ ОТДЕЛЬНЫХ НЕОТЛОЖНЫХ СОСТОЯНИЯХ И У СПЕЦИФИЧЕСКИХ ГРУПП ПАЦИЕНТОВ. РЕКОМЕНДАЦИИ ЕВРОПЕЙСКОГО СОВЕТА ПО РЕАНИМАТОЛОГИИ 2021 ГОДА

New European Resuscitation Council Guidelines are discussed in the paper. European Resuscitation Council (ERC) Cardiac Arrest in Special Circumstances guidelines are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. This section provides guidelines on the modifications required to basic and advanced life support for the prevention and treatment of cardiac arrest in special circumstances; specifically special causes (hypoxia, trauma, anaphylaxis, sepsis, hypo/hyperkalaemia and other electrolyte disorders, hypothermia, avalanche, hyperthermia and malignant hyperthermia, pulmonary embolism, coronary thrombosis, cardiac tamponade, tensionpneumothorax, toxic agents), special settings (operating room, cardiac surgery, catheter laboratory, dialysis unit, dental clinics, transportation (in-flight, cruise ships), sport, drowning, mass casualty incidents), and special patient groups (asthma and COPD, neurological disease, obesity, pregnancy). There are no major changes in the 2021 adult Special Circumstances guidelines. There is greater emphasis on the priorisation of recognition and management for reversible causes in cardiac arrest due to special circumstances. The guidelines reflect the increasing evidence for extracorporeal CPR (eCPR) as management strategy for selected patients with cardiac arrest in settings in which it can be implemented. Diagnostic criteria and therapeutic approaches are discussed.

Teamwork and Leadership in Out-of-Hospital Cardiac Arrest – Do These Non-Technical Skills Require Attention?

The science of cardiopulmonary resuscitation (CPR) is now well established and incorporated into training programs to maximise patient survival. There is an increased understanding that non-technical skills such as teamwork and leadership can play a vital role in improving CPR quality, patient outcomes and clinician occupational health. Despite this, these non-technical skills remain somewhat neglected in the context of out-of-hospital cardiac arrest. With reference to the literature this commentary provides a discussion to reinforce the need for a greater focus to this area of practice and build a case for further research and training.

2019 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

The International Liaison Committee on Resuscitation has initiated a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation science. This is the third annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. It addresses the most recent published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. This summary addresses the role of cardiac arrest centers and dispatcher-assisted cardiopulmonary resuscitation, the role of extracorporeal cardiopulmonary resuscitation in adults and children, vasopressors in adults, advanced airway interventions in adults and children, targeted temperature management in children after cardiac arrest, initial oxygen concentration during resuscitation of newborns, and interventions for presyncope by first aid providers. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the certainty of the evidence on the basis of the Grading of Recommendations, Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence to Decision Framework Highlights sections. The task forces also listed priority knowledge gaps for further research.

2019 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces.

The International Liaison Committee on Resuscitation has initiated a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation science. This is the third annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. It addresses the most recent published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. This summary addresses the role of cardiac arrest centers and dispatcher-assisted cardiopulmonary resuscitation, the role of extracorporeal cardiopulmonary resuscitation in adults and children, vasopressors in adults, advanced airway interventions in adults and children, targeted temperature management in children after cardiac arrest, initial oxygen concentration during resuscitation of newborns, and interventions for presyncope by first aid providers. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the certainty of the evidence on the basis of the Grading of Recommendations, Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence to Decision Framework Highlights sections. The task forces also listed priority knowledge gaps for further research.

Compose the splendid passages of "heart" for the age of health: theory and practice of "three construction" strategy of cardiopulmonary resuscitation in China

Cardiac arrest is an emergency that threatens the safety of human life. Cardiopulmonary resuscitation, as the key technology, has always attracted much attention. Based on the practice on the health of life, the Cardiopulmonary Resuscitation Specialized Committee of Chinese Research Hospital Association, Cardiopulmonary Resuscitation Specialized Committee of Chinese Aging Well Association, Health Culture Committee of Chinese Health Association, the 10th Science Popularization Branch of the Chinese Medical Association, is facing the life of the people's "to die in an old age". From the force "to bring back to life" of the cardiopulmonary resuscitation, the author constructs the scientific theory of cardiopulmonary resuscitation, the base of the scientific and technical personnel of the cardiopulmonary resuscitation, and the mass of the popularization of the cardiopulmonary resuscitation. The scientific theory system, the technological team, and the benefit to the people are focused. It has promoted the popularization and promotion of the cardiopulmonary resuscitation science and technology, and obtained the great achievements of the scientific and technological innovation and the scientific popularization of the cardiopulmonary resuscitation, which arethe cultural connotations of the "heart" of the life and health.

2018 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations Summary.

The International Liaison Committee on Resuscitation has initiated a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation science. This is the second annual summary of International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations that includes the most recent cardiopulmonary resuscitation science reviewed by the International Liaison Committee on Resuscitation. This summary addresses the role of antiarrhythmic drugs in adults and children and includes the Advanced Life Support Task Force and Pediatric Task Force consensus statements, which summarize the most recent published evidence and an assessment of the quality of the evidence based on Grading of Recommendations, Assessment, Development, and Evaluation criteria. The statements include consensus treatment recommendations approved by members of the relevant task forces. Insights into the deliberations of each task force are provided in the Values and Preferences and Task Force Insights sections. Finally, the task force members have listed the top knowledge gaps for further research.

2018 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations Summary

The International Liaison Committee on Resuscitation has initiated a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation science. This is the second annual summary of International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations that includes the most recent cardiopulmonary resuscitation science reviewed by the International Liaison Committee on Resuscitation. This summary addresses the role of antiarrhythmic drugs in adults and children and includes the Advanced Life Support Task Force and Pediatric Task Force consensus statements, which summarize the most recent published evidence and an assessment of the quality of the evidence based on Grading of Recommendations, Assessment, Development, and Evaluation criteria. The statements include consensus treatment recommendations approved by members of the relevant task forces. Insights into the deliberations of each task force are provided in the Values and Preferences and Task Force Insights sections. Finally, the task force members have listed the top knowledge gaps for further research.

2018 National consensus on cardiopulmonary resuscitation training in China

To promote the technical training and scientific popularization of cardiopulmonary resuscitation (CPR) in China, the Cardiopulmonary Resuscitation Specialized Committee of Chinese Research Hospital Association combined with the Science Popularization Branch of the Chinese Medical Association wrote "2018 National consensus on cardiopulmonary resuscitation training in China". The formation was based on the general outline about "2016 National consensus on cardiopulmonary resuscitation in China", and to implement the important strategies included the "three pre" policy, prevention, precognition, and pre-warning, before the cardiac arrest (CA); the "three modernization" methods, standardized, diversified and individualized, during the CA; and the "three life" strategies, the rebirth, the extra and the extended, after the CA; and also combined with the concrete National conditions and clinical practice of China area. The document summarized the evidence of published science about CPR training till now, and recommend the establishment of "the CPR Training Triangle" according to the Chinese National conditions. The bases of the triangle were system, training and person, the core of which was CPR science. The main contents were: (1) The "three training" policy for CPR training: the cultivation of a sound system, which included professional credibility, extensive mobilization and continuous driving force, and the participation of the whole people and continuous improvement; the cultivation of scientific guidelines, which included scientific content, methods and thinking; and the cultivation of a healthy culture, which included the enhancement of civic quality, education of rescue scientifically, and advocate of healthy life. (2) The "three training" program of CPR training: training professional skills, which included standard, multiple, and individual skills; training multidimensional, which included time, space, and human; and training flexible, including problem, time, and innovation oriented. (3) The "three party" direction of CPR training, the application for achievement translation, which included scientific translations, skill propagators, and cultural advocates; the precision disseminators, which included accurate communication sources, channels, and dissemination of the audience; and theoretical innovation guides, which included scientific, popular science and communication theory. That integrated the wisdom of scholars, melt the thought of genius, and created the act of envoy for Chinese and foreign CPR training. The training program should be suitable for different trainee, no matter who is trainer or trainee. The release of the expert consensus on the 2018 CPR training will make the National CPR education into the new training era with definite direction, clear target and fully standard of China.

2017 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations Summary.

The International Liaison Committee on Resuscitation has initiated a near-continuous review of cardiopulmonary resuscitation science that replaces the previous 5-year cyclic batch-and-queue approach process. This is the first of an annual series of International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations summary articles that will include the cardiopulmonary resuscitation science reviewed by the International Liaison Committee on Resuscitation in the previous year. The review this year includes 5 basic life support and 1 pediatric Consensuses on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Each of these includes a summary of the science and its quality based on Grading of Recommendations, Assessment, Development, and Evaluation criteria and treatment recommendations. Insights into the deliberations of the International Liaison Committee on Resuscitation task force members are provided in Values and Preferences sections. Finally, the task force members have prioritized and listed the top 3 knowledge gaps for each population, intervention, comparator, and outcome question.

2017 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations Summary

The International Liaison Committee on Resuscitation has initiated a near-continuous review of cardiopulmonary resuscitation science that replaces the previous 5-year cyclic batch-and-queue approach process. This is the first of an annual series of International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations summary articles that will include the cardiopulmonary resuscitation science reviewed by the International Liaison Committee on Resuscitation in the previous year. The review this year includes 5 basic life support and 1 paediatric Consensuses on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Each of these includes a summary of the science and its quality based on Grading of Recommendations, Assessment, Development, and Evaluation criteria and treatment recommendations. Insights into the deliberations of the International Liaison Committee on Resuscitation task force members are provided in Values and Preferences sections. Finally, the task force members have prioritised and listed the top 3 knowledge gaps for each population, intervention, comparator, and outcome question.

European Resuscitation Council and European Society of Intensive Care Medicine 2015 guidelines for post-resuscitation care.

The European Resuscitation Council and the European Society of Intensive Care Medicine have collaborated to produce these post-resuscitation care guidelines, which are based on the 2015 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. Recent changes in post-resuscitation care include: (a) greater emphasis on the need for urgent coronary catheterisation and percutaneous coronary intervention following out-of-hospital cardiac arrest of likely cardiac cause; (b) targeted temperature management remains important but there is now an option to target a temperature of 36 °C instead of the previously recommended 32-34 °C; (c) prognostication is now undertaken using a multimodal strategy and there is emphasis on allowing sufficient time for neurological recovery and to enable sedatives to be cleared; (d) increased emphasis on rehabilitation after survival from a cardiac arrest.

Chest Compression Rate

The first description of modern cardiopulmonary resuscitation (CPR) included the instruction to compress the chest “about 60 times per minute”1; however, the optimal compression rate was unknown. Franz Koenig is credited with describing the original technique for external cardiac massage, which included a compression rate of 30 to 40 per minute.2 But in the first published description of external cardiac massage in 1892, Friedrich Maass documented a better clinical response with a rate of 120 per minute.2 To this day, the optimal compression rate is the subject of controversy. Animal data indicate that cardiac output increases with compression rates up to as high as 150 per minute.3 In a canine model of prolonged cardiac arrest, compression rates of 120 per minute compared with 60 per minute increased mean aortic (systolic and diastolic) and coronary perfusion pressures, and 24-hour survival (61% versus 15%, P =0.03).4 In a study of 9 patients undergoing CPR, a compression rate of 120 per minute generated higher aortic peak pressures and coronary perfusion pressures compared with a compression rate of 60 per minute (the rate recommended by the 1980 American Heart Association [AHA] guidelines). This evidence is supported by another study of 23 patients in cardiac arrest in which compressions at 120 per minute resulted in significantly higher end-tidal carbon dioxide values compared with compressions at 80 per minute.5 Article see p 3004 The first large, prospective, observational study of the influence of chest compression rate on patient survival was published in this journal in 2005.6 The number of delivered chest compressions was recorded by trained observers during in-hospital resuscitation attempts. A higher chest compression rate was associated with a higher rate of return of spontaneous circulation (ROSC). The mean chest compression rate for initial survivors was 90 …

Advances in Cardiopulmonary Resuscitation

This article focuses on important advances in the science of cardiopulmonary resuscitation in the last decade that have led to a significant improvement in understanding the complex physiology of cardiac arrest and critical interventions for the initial management of cardiac arrest and postresuscitation treatment. Special emphasis is given to the basic simple ways to improve circulation, vital organ perfusion pressures, and the grave prognosis of sudden cardiac death.

Resuscitation guidelines 2010: a scientific consensus

Resuscitation guidelines 2010: a scientific consensus

European Resuscitation Council Guidelines for Resuscitation 2010 Section 1. Executive summary

The publication of these European Resuscitation Council (ERC) Guidelines for cardiopulmonary resuscitation (CPR) updates those that were published in 2005 and maintains the established 5-yearly cycle of guideline changes.1 Like the previous guidelines, these 2010 guidelines are based on the most recent International Consensus on CPR Science with Treatment Recommendations (CoSTR),2 which incorporated the results of systematic reviews of a wide range of topics relating to CPR. Resuscitation science continues to advance, and clinical guidelines must be updated regularly to reflect these developments and advise healthcare providers on best practice.

Advances in Cardiopulmonary Resuscitation.

This article focuses on important advances in the science of cardiopulmonary resuscitation (CPR) in the last decade that have led to a significant improvement in understanding the complex physiology of cardiac arrest and critical interventions for the initial management of cardiac arrest and postresuscitation treatment. Special emphasis is given to the basic simple ways to improve circulation, vital organ perfusion pressures, and the grave prognosis of sudden cardiac death.

Scientific Knowledge Gaps and Clinical Research Priorities for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Identified During the 2005 International Consensus Conference on ECC and CPR Science With Treatment Recommendations

Scientific Knowledge Gaps and Clinical Research Priorities for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Identified During the 2005 International Consensus Conference on ECC and CPR Science With Treatment Recommendations

Major Changes in the 2005 AHA Guidelines for CPR and ECC

The emergency cardiovascular care (ECC) scientists involved in the 2005 evidence evaluation process and the revision of the 2005 AHA Guidelines for CPR and ECC began and ended the process aware of the limitations of the resuscitation scientific evidence, optimistic about emerging data that documents the benefits of high-quality cardiopulmonary resuscitation (CPR), and determined to make recommendations that would increase survival from cardiac arrest and life-threatening emergencies. This editorial summarizes the factors that contributed to the tipping point, the point at which information and discussion either triggered support for major changes in the guidelines or reaffirmed existing recommendations. The scientists critically reviewed the sequence and priorities of the steps of CPR to identify those factors with the greatest potential impact on survival. They then developed recommendations to support those interventions that should be performed frequently and well. There was unanimous support for increased emphasis on ensuring that rescuers deliver high-quality CPR: rescuers need to provide an adequate number and depth of compressions, allow complete chest recoil after each compression, and minimize interruptions in chest compressions. The 2005 AHA Guidelines for CPR and ECC are based on the most comprehensive review of resuscitation literature ever published.1 The evidence evaluation process incorporated the input of 281 international resuscitation experts who evaluated research, topics, and hypotheses over a 36-month period before the 2005 Consensus Conference. The process included structured evidence evaluation, analysis, and documentation of the literature.2 It also included rigorous disclosure and management of potential conflicts of interest, a process summarized in two editorials.3,4 Cardiopulmonary resuscitation and emergency cardiovascular care is a relatively new field. The epidemiologic data is incomplete, and high-level evidence is insufficient to support many recommendations. Although sudden cardiac arrest (SCA) is responsible for an estimated 250 000 deaths out of the hospital in the United …

Recomendaciones internacionales en resucitación: del empirismo a la medicina basada en la evidencia

Los días 23 a 29 de enero de 2005, la ciudad de Dallas (Texas, EE.UU.) ha acogido la celebración de la Conferencia Internacional de Consenso sobre la Ciencia de la Resucitación Cardiopulmonar y de los Cuidados Cardiovasculares de Emergencias con Recomendaciones sobre Tratamiento (International Consensus Conference on CPR & ECC Science with Treatment Recomendations) convocada por el International Liaison Committee on Resuscitation (ILCOR) y abreviada como ILCOR 2005 International CoSTR Conference o ILCOR C2005. La participación en la conferencia sólo podía realizarse por invitación y el Plan Nacional de RCP fue invitado a participar con la función específica de realizar aportaciones durante la fase de discusión de las sesiones, basadas en su experiencia educativa desde 1986. Anteriormente se habían llevado a cabo conferencias similares en 1966, 1973, 1979, 1985, 1992 y 2000, pero ILCOR C2005 se ha diferenciado de todas ellas al centrarse sólo en el análisis de la evidencia científica sobre la que los diferentes consejos de resucitación podrán elaborar posteriormente sus recomendaciones. Si hubiera que elegir un titular periodístico para describir esta conferencia, sin duda sería el de “Resucitación basada en la evidencia”. On January 23rd to 29th, 2005, in the city of Dallas (Texas, USA), the International Consensus Conference of the Science of Cardiopulmonary Resuscitation and Emergency Cardiovascular Care with Treatment Recommendations, organized by the International Liaison Committee on Resuscitation (ILCOR) and abbreviated as ILCOR 2005 International CoSTR Conference or ILCOR C2005, was held. Participation in the conference could only be done by invitation and the National CPR Plan was invited to participate with the specific function of making contributions during the session discussion phase, based on their educational experience since 1986. Previously, similar conferences had been conducted in 1966, 1973, 1979, 1985, 1992 and 2000, but ILCOR C2005 has differed from all of them because it has only focused on the analysis of scientific evidence on which the different resuscitation boards could then elaborate their recommendations. If a newspaper headline had to be chosen to describe this conference, it would undoubtedly be that of “Evidence based resuscitation”.

Cardiopulmonary resuscitation: a promise as yet largely unfulfilled.

After failure of initial external defibrillation, restoration of spontaneous circulation is largely contingent on rapid and effective reversal of myocardial ischemia by both mechanical and pharmacologic means. Despite the introduction of modern cardiopulmonary resuscitation (CPR) more than 35 years ago, its universal acceptance, and its wide implementation, no improvements in outcome excepting early defibrillation have been documented over these many years. The science of CPR therefore is still in its infancy. It was incorrectly assumed that all that needs to be known is known and that the need for scientific research was therefore not apparent. Accordingly, serious resuscitation research was neither encouraged nor equitably supported. The ABCs of CPR currently provide for the establishment of a patent airway (A) and intermittent positive pressure ventilation, preferably with oxygen-enriched air (B). These are to be immediately followed with precordial compression (C). This ordering of priorities, however, is based on consensus rather than objective outcome measurements. The ABCs recently have been seriously challenged on the basis of results of both experimental and clinical studies. Conventional external precordial compression restores systemic blood flow. It may be used by both professional and nonprofessional CPR providers, especially bystanders, because of its apparent simplicity and noninvasiveness. However, manual or mechanical external precordial compression typically generates cardiac outputs that represent less than 30% of normal values. Coronary blood flow, which is critical for restoration of spontaneous circulation, is correspondingly reduced. Accordingly, several alternatives to conventional precordial compression have been proposed with the intent of increasing cardiac output and both coronary and cerebral blood flows. Among the large number of pharmaceutical agents initially recommended for cardiac resuscitation, only agents that produce peripheral vasoconstriction are of proved benefit. Epinephrine has been the preferred vasopressor agent for the management of cardiac arrest for more than 35 years because of its alpha-adrenergic effects. However, the potentially adverse effects of epinephrine are related to its beta-adrenergic inotropic actions. The beta-adrenergic actions account for disproportionate increases in myocardial oxygen consumption with increased severity of myocardial ischemic injury and provocation of ectopic ventricular tachycardia and ventricular fibrillation. Nevertheless, epinephrine remains the drug of choice, although adrenergic drugs with selective alpha-adrenergic actions or nonadrenergic vasoconstrictor drugs are likely to emerge as useful alternatives. Experimental and clinical observations have led to identification of continuous monitoring of both end-tidal carbon dioxide and ventricular fibrillation waveforms as practical noninvasive guides because they are highly correlated with both cardiac output and coronary blood flow. Both end-tidal carbon dioxide and ventricular fibrillation waveforms now serve as predictors of the likelihood of successful resuscitation. These two measurements may now be used to guide interventions and especially to assure optimal precordial compression. It is well established that sudden death among adults is predominantly due to malignant ventricular arrhythmias and ventricular fibrillation. Early defibrillation serves as an unequivocally effective immediate intervention. Minimally trained first responders and members of the general public are being enfranchised to use automated external defibrillators for very early defibrillation. Use of these devices by bystanders is the most promising new intervention since CPR was first proposed in the early 1960s. Postresuscitation ventricular dysrhythmias and heart failure are now called postresuscitation myocardial dysfunction. This complication has been recognized as a leading cause of the high postresuscitation mor