Subscribe to RSS
DOI: 10.1055/s-2007-966600
© Georg Thieme Verlag KG Stuttgart · New York
Was ist neu in den Reanimationsleitlinien für den Erwachsenen?
Publication History
Publication Date:
06 July 2007 (online)
![](https://www.thieme-connect.de/media/kardiologie-u2d/200702/lookinside/thumbnails/10.1055-s-2007-966600-1.jpg)
Kernaussagen
Die neuen Leitlinien zur kardiopulmonalen Reanimationen stellen die Bedeutung der Herzdruckmassage in den Vordergrund. Die Wiederbelebung beginnt mit der Herzdruckmassage, das Verhältnis von Herzdruckmassage zu Beatmung ist auf 30 : 2 geändert. Im Falle der Unwilligkeit des Helfers zu beatmen, wird die Herzdruckmassage als Alleinmaßnahme akzeptiert. Um die Pausen der Thoraxkompression maximal zu reduzieren, wird nur noch einmal defibrilliert und nicht mehr in Serien von 3 Schocks, dabei werden nach jedem Schock die mechanischen Reanimationsmaßnahmen über 2 Minuten fortgesetzt. Amiodaron ist das Antiarrhythmikum der Wahl bei schockrefraktärem Kammerflimmern. In der Nachbehandlung kommt der therapeutischen Hypothermie eine entscheidende Bedeutung zu. Der Algorithmus zur Basisreanimation gilt für alle Reanimationssituationen mit Ausnahmen der Reanimation des Neugeborenen und des Säuglings.
Literatur
- 1 International Liaison Committee on resuscitation . 2005 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Resuscitation. 2005; 67 157-337
- 2 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2005; 112 (Suppl IV) b2-205
- 3 European Resuscitation Council Guidelines for Resuscitation 2005. Resuscitation. 2005; 67 (Suppl. I) S1-S181 (eine vollständige autorisierte deutsche Übersetzung ist in Notfall & Rettungsmedizin 2006; 9 : 6-163 erschienen)
- 4 Kouwenhoven W B, Jude J R, Knickerbocker G G. Closed-chest cardiac massage. JAMA. 1960; 173 1064-1067
- 5 Valenzuela T D, Roe D J, Cretin S, Spaite D W, Larsen M P. Estimating effectiveness of cardiac arrest interventions: a logistic regression survival model. Circulation. 1997; 96 3308-3313
- 6 Valenzuela T D, Roe D J, Nichol G, Clark L L, Spaite D W, Hardman R G. Outcomes of rapid defibrillation by security officers after cardiac arrest in casinos. NEJM. 2000; 343 1206-1209
- 7 Locke C J, Berg R A, Sanders A B, Davis M F, Milander M M, Kern K B, Ewy G A. Bystander cardiopulmonary resuscitation. Concerns about mouth-to-mouth contact. Arch Intern Med. 1995; 55 938-943
- 8 Hallstrom A, Cobb L, Johnson E, Copass M. Cardiopulmonary resuscitation by chest compression alone or with mouth-to-mouth ventilation. N Engl J Med. 2000; 342 1546-1553
- 9 Assar D, Chamberlain D, Colquhoun M, Donnelly P, Handley A J, Leaves S, Kern K B. Randomised controlled trials staged teaching for basic life support. 1. Skill acquisition at bronze stage. Resuscitation. 2000; 45 7-15
- 10 O’Rourke M F, Donaldson E, Geddes J S. An airline cardiac arrest program. Circulation. 1997; 96 2849-2853
- 11 Outcomes of rapid defibrillation by security officers after cardiac arrest in casinos. N Engl J Med. 2000; 343 1206-1209
- 12 Hallstrom A P, Ornato J P, Weisfeldt M, Travers A, Christenson J, McBurnie M A, Zalenski R, Becker L B, Schron E B, Proschan M . Public Access Defibrillation Trial Investigators . Public-access defibrillation and survival after out-of-hospital cardiac arrest. N Engl J Med. 2004; 351 637-646
- 13 Caffrey S L, Willoughby P J, Pepe P E, Becker L B. Public use of automated external defibrillators. NEJM. 2002; 347 1242-1247
- 14 Morrison L J, Dorian P, Long J. et al . Out-of-hospital cardiac arrest rectilinear biphasic to monophasic damped sine defibrillation waveforms with advanced life support intervention trial (ORBIT). Resuscitation. 2005; 66 149-157
- 15 Schneider T, Martens P R, Paschen H. et al . Multicenter, randomized, controlled trial of 150-J biphasic shocks compared with 200- to 360-J monophasic shocks in the resuscitation of out-of-hospital cardiac arrest victims. Optimized Response to Cardiac Arrest (ORCA) Investigators. Circulation. 2000; 102 1780-1787
- 16 Kudenchuk P J, Cobb L A, Copass M K, Olsufka M, Maynard C, Nichol G. Transthoracic incremental monophasic versus biphasic defibrillation by emergency responders (TIMBER): a randomized comparison of monophasic with biphasic waveform ascending energy defibrillation for the resuscitation of out-of-hospital cardiac arrest due to ventricular fibrillation. Circulation. 2006; 114 2010-2018
- 17 Wik L, Hansen T B, Fylling F. et al . Delaying defibrillation to give basic cardiopulmonary resuscitation to patients with out-of-hospital ventricular fibrillation: a randomized trial. Jama. 2003; 289 1389-1395
- 18 Yu T, Weil M H, Tang W, Sun S, Klouche K, Povoas H, Bisera J. Adverse outcomes of interrupted precordial compression during automated defibrillation. Circulation. 2002; 106 368-372
- 19 Gueugniaud P Y, Mols P, Goldstein P, Pham E, Dubien P Y, Deweerdt C, Vergnion M, Petit P, Carli P. A comparison of repeated high doses and repeated standard doses of epinephrine for cardiac arrest outside the hospital. European Epinephrine Study Group. N Engl J Med. 1998; 339 1595-1601
- 20 Wenzel V, Krismer A C, Arntz H R, Sitter H, Stadlbauer K H, Lindner K H;. A comparison of vasopressin and epinephrine for out-of-hospital cardiopulmonary resuscitation. N Engl J Med. 2004; 350 105-113
- 21 Sadowski Z P, Alexander J H, Skrabucha B. et al . Multicenter randomized trial and a systematic overview of lidocaine in acute myocardial infarction. Am Heart J. 1999; 137 792-798
- 22 Kudenchuk P J, Cobb L A, Copass M K. et al . Amiodarone for resuscitation after out-of-hospital cardiac arrest due to ventricular fibrillation. N Engl J Med. 1999; 341 871-878
- 23 Dorian P, Cass D, Schwart B, Cooper R, Gelaznikas R, Barr A. Amiodarone as compared with lidocaine for shock-resistant ventricular fibrillation. NEJM. 2002; 346 884-890
- 24 Abu-Laban R B, McIntyre C M, Christenson J M. et al . Aminophylline in bradyasystolic cardiac arrest: a randomised placebo-controlled trial. Lancet. 2006; 367 1577-1584
- 25 Abu-Laban R B, Christenson J M, Innes G D. et al . Tissue plasminogen activator in cardiac arrest with pulseless electrical activity. Engl J Med. 2002; 346 1522-1528
- 26 Böttiger B. Ergebnisse der TROICA (Thrombolysis in Cardiac Arrest) Studie, vorgetragen beim Kongress der European Society of Cardiology. Barcelona; September 2006
- 27 Hypothermia a fter. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med. 2002; 346 549-556
- 28 Nolan J P, Morley P T, Vanden H oek. et al . Therapeutic hypothermia after cardiac arrest: an advisory statement by the advanced life support task force of the International Liaison Committee on Resuscitation. Circulation. 2003; 108(1) 118-121
Prof. Dr. med. Hans-Richard Arntz
Charité, Campus Benjamin Franklin
Med. Klinik II, Kardiopulmologie
Hindenburgdamm 30
12200 Berlin
Email: hans-richard.arntz@charite.de