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DOI: 10.1055/s-2007-995749
© Georg Thieme Verlag KG Stuttgart · New York
Mechanische Reanimationshilfen: Neue Entwicklungen und erste Ergebnisse
Publication History
Publication Date:
06 June 2008 (online)
![](https://www.thieme-connect.de/media/kardiologie-u2d/200802/lookinside/thumbnails/10.1055-s-2007-995749-1.jpg)
Abstract
Cardiopulmonary resuscitation (CPR) is associated with a poor prognosis. Recent data suggest that chest compressions, even when performed by qualified persons, are often suboptimal. In clinical and laboratory studies, continuous chest compression can improve coronary perfusion pressures as a prerequisite for the restoration of circulation as compared with conventional CPR with chest compressions and ventilations. Results from animal studies clearly show that continuous chest compression performed by devices can improve the outcome after CPR compared to manual compressions. Currently, two devices for CPR are commercially available, LUCAS and AutoPulse. Few clinical studies have been performed with these devices, showing a trend towards a better restoration of spontaneous circulation. The effect of device-assisted CPR on long-term survival or neurologic status has not been addressed yet. Data are inconsistent, and the broad use of these devices currently can not be recommended on the basis of evidence. They may, however, be useful in selected patients, especially when the basic condition leading to CPR is likely to be reversed during prolonged measures, such as hyperkalemia or pulmonary embolism. The article summarizes currently available clinical data and the author’s experiences with the devices.
Kernaussagen
Trotz Modifikationen der Reanimationsalgorithmen in den letzten Jahren sind die Langzeitergebnisse der kardiopulmonalen Reanimation immer noch unbefriedigend. In einer Reihe von Studien konnte gezeigt werden, dass die manuelle Thoraxkompression, auch wenn sie von erfahrenem Personal durchgeführt wird, nicht so effektiv ist, wie es die Leitlinien erfordern.
Mechanische Reanimationshilfen zur Thoraxkompression stellen theoretisch - aufgrund der konstant applizierten Kompression ohne Notwendigkeit, die einer Unterbrechung für Maßnahmen wie z. B. eine Defibrillation - eine sinnvolle Ergänzung der Reanimation dar. Im Tierversuch sind sie der manuellen Reanimation eindeutig überlegen. Klinische Daten sind jedoch, am ehesten aufgrund sehr heterogener Patientenkollektive in den wenigen durchgeführten Studien, uneinheitlich.
Der globale, unkritische Einsatz der aktuell verfügbaren mechanischen Reanimationshilfen kann nicht generell empfohlen werden. Ein differenzierter Einsatz bei klarer Indikationsstellung und idealerweise eine wissenschaftliche Aufarbeitung der behandelten Fälle scheint jedoch ein sinnvoller Weg, um den definitiven Nutzen dieser Methode in der Zukunft klären zu können.
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PD Dr. Gregor Simonis
Klinik für Innere Medizin/Kardiologie und Intensivmedizin
Herzzentrum Dresden Universitätsklinik an der TU Dresden
Fetscherstr. 76
01307 Dresden
Email: gsimonis@gmx.de