Kardiopulmonale Reanimation (CPR)[1]

Zusammenfassung

Die aktuell gültigen Leitlinien des European Resuscitation Council (ERC) zur Reanimation geben keine eindeutigen Empfehlungen zum „Transport unter CPR“. Darüber hinaus existieren bis heute keine generell akzeptierten Abbruchkriterien der CPR, außer bei sicheren Todeszeichen. Bei insgesamt schlechtem Outcome für unter CPR-Bemühungen transportierte Patienten gibt es jedoch immer wieder positive Einzelfallberichte und unstrittige Indikationen (z. B. bei potenziell reversibler Ursache des Herz-Kreislauf-Stillstands). Die in den letzten Jahren zu beobachtenden ansteigenden Transportraten unter CPR sind bislang nicht durch eine verbesserte Prognose dieser Patienten zu rechtfertigen. Der Einsatz automatischer Reanimationshilfen mit einer besseren Qualität von Thoraxkompressionen auch unter Transportbedingungen mag einen Einfluss auf die Transportraten haben, ist bisher jedoch hinsichtlich des Patienten-Outcome nur unzureichend evaluiert. Letztlich bleibt die Entscheidung zum Transport eine individuelle Entscheidung des Notarztes, die in Abhängigkeit der im Einzelfall evaluierten Prognose des Patienten zu sehen ist.

Abstract

The currently valid guidelines for resuscitation of the European Resuscitation Council (ERC) do not give any unambiguous recommendations for „transport with ongoing cardiopulmonary resuscitation“. Furthermore, up to now there are no generally accepted criteria for terminating cardiopulmonary resuscitation, apart from certain signs of death. In spite of the generally poor outcome of patients being transported with ongoing cardiopulmonary resuscitation, there are a number of positive case reports and undisputable indications (e. g., in cases with a potentially reversible cause of cardiac arrest). The increase observed over the past few years in the number of patients being transported under cardiopulmonary resuscitation has as yet not been reflected in an improved prognosis for these patients. The use of mechanical chest compression devices with a better quality of chest compression, also under transport conditions, may have an influence on the number transports but this has not yet been evaluated sufficiently with regard to patient outcome. However, the decision to transport a patient resides with the responsible emergency physician who has to evaluate the prognosis for the patient on an individual basis.

Schlüsselwörter

außerklinischer Herz-Kreislauf-Stillstand - kardiopulmonale Reanimation - prolongierte CPR - Transport

Keywords

out-of-hospital cardiac arrest - cardiopulmonary resuscitation - ongoing CPR - transport

1 Erstveröffentlichung des Beitrags in: Anästhesiol Intensivmed Notfallmed Schmerzther 2011; 46: 402–407.

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1 Erstveröffentlichung des Beitrags in: Anästhesiol Intensivmed Notfallmed Schmerzther 2011; 46: 402–407.