Paro cardiaco / Cardiac arrest

Noviembre 5, 2017. No. 2893

Epinefrina en el paro cardíaco fuera del hospital: ¿Útil o perjudicial? Epinephrine in Out-of-hospital Cardiac Arrest: Helpful or Harmful? Shao H1, Li CS1. Author information Chin Med J (Engl). 2017 Sep 5;130(17):2112-2116. doi: 10.4103/0366-6999.213429. Abstract OBJECTIVE: Epinephrine is the primary drug administered during cardiopulmonary resuscitation (CPR) to reverse cardiac arrest. The evidence for the use of adrenaline in out-of-hospital cardiac arrest (OHCA) and in-hospital resuscitation is inconclusive. We conducted a systematic review on the clinical efficacy of adrenaline in adult OHCA patients to evaluate whether epinephrine provides any overall benefit for patients. DATA SOURCES: The EMBASE and PubMed databases were searched with the key words "epinephrine," "cardiac arrest," and variations of these terms. STUDY SELECTION: Data from clinical randomized trials, meta-analyses, guidelines, and recent reviews were selected for review. RESULTS: Sudden cardiac arrest causes 544,000 deaths in China each year, with survival occurring in <1% of cases (compared with 12% in the United States). The American Heart Association recommends the use of epinephrine in patients with cardiac arrest, as part of advanced cardiac life support. There is a clear evidence of an association between epinephrine and increased return of spontaneous circulation (ROSC). However, there are conflicting results regarding long-term survival and functional recovery, particularly neurological outcome, after CPR. There is currently insufficient evidence to support or reject epinephrine administration during resuscitation. We believe that epinephrine may have a role in resuscitation, as administration of epinephrine during CPR increases the probability of restoring cardiac activity with pulses, which is an essential intermediate step toward long-term survival. CONCLUSIONS: The administration of adrenaline was associated with improved short-term survival (ROSC). However, it appears that the use of adrenaline is associated with no benefit on survival to hospital discharge or survival with favorable neurological outcome after OHCA, and it may have a harmful effect. Larger placebo-controlled, double-blind, randomized control trials are required to definitively establish the effect of epinephrine. PDF El papel del centro de despacho en la reanimación. The role of dispatch in resuscitation. Ng YY1, Leong SH2, Ong ME3,4. Author information Singapore Med J. 2017 Jul;58(7):449-452. doi: 10.11622/smedj.2017059. Abstract The role of the dispatch centre has increasingly become a focus of attention in cardiac arrest resuscitation. The dispatch centre is part of the first link in the chain of survival because without the initiation of early access, the rest of the chain is irrelevant. The influence of dispatch can also extend to the initiation of bystander cardiopulmonary resuscitation, early defibrillation and the rapid dispatch of emergency ambulances. The new International Liaison Committee on Resuscitation, the American Heart Association and, especially, the European ResuscitationCouncil 2015 guidelines have been increasing their emphasis on dispatch as the key to improving out-of-hospital cardiac arrest survival. KEYWORDS: cardiopulmonary resuscitation; dispatcher-assisted CPR; primary safety access point; public access defibrillation; telephone CPR PDF LI Congreso Mexicano de Anestesiología Mérida Yucatán, Noviembre 21-25, 2017 Información / Information

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