Zukunftsorientierte Weiterentwicklung einer „individualisierten“ kardiopulmonalen Reanimation
摘要
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.