Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

New concept: Can Resuscitation be delayed?

31.03.2015

Team of researchers lay the foundation for new resuscitation guidelines for severely hypothermic patients in cardiac arrest

The general rule for treatment of patients in cardiac arrest is that once resuscitation measures have begun, they must be continued uninterruptedly until the patient shows signs of life or is pronounced dead. A new study has shown that in the specific case of severely hypothermic victims with a core body temperature below 28°C, resuscitation can be delayed and periodically interrupted for short intervals during transportation in the mountains without jeopardising survival.

The study has just been published in the medical journal “Resuscitation” and was conducted by Cumbrian Mountain Rescue doctors, the Glenfield Hospital, Leicester in the UK, EURAC in Italy, the Medical University of Innsbruck in Austria and Stanford University in California, USA.

In remote and mountain areas rescuers are often faced with the predicament that uninterrupted resuscitation is simply not possible during transportation of cardiac arrest patients to the hospital. In these cases cardiopulmonary resuscitation (CPR) may be interrupted at the scene or during evacuation.

In recent years, however, there have been some case reports in the Alps of severely hypothermic accident victims in cardiac arrest who have survived without any permanent damage despite several interruptions of chest compressions. Rescue services have been seeking urgent clarification of the circumstances when this may apply, as current recommendations specify uninterrupted resuscitation under all circumstances.

The authors did a literature review that has led to the conclusion that short interruptions of CPR for the purposes of transportation can be made during resuscitation with severely hypothermic patients. Low body temperature preserves the brain, enabling it to withstand cardiac arrest for considerably longer than at normal body temperature. The researchers looked at data from cardiac and vascular surgery, as deliberately lowering the patient’s body temperature during the surgery is a recognised technique.

Under this induced deep hypothermia, surgeons are able to briefly stop the heart while performing procedures on the heart or large vessels close to the heart without increasing the risk of permanent brain damage. “We have carried out a comprehensive case analyses in this study and have extended what we know from cardiovascular surgery to severe accidental hypothermia.

Based on the results, we propose a structured protocol that will enable rescuers and emergency doctors to interrupt CPR for defined periods of time in severely hypothermic patients so that patients can be moved,” explained Dr Les Gordon. In practice, this means that if severely hypothermic cardiac arrest patients with body temperature below 28°C need to be evacuated from difficult terrain and continuous resuscitation is not possible, it is justified to alternate five minutes of CPR with five minutes of transportation and continue this pattern until continuous resuscitation can be started.

This facilitates rescue and transportation of the patient to a hospital with extracorporeal life support for rewarming without having to abandon potentially life-saving resuscitation attempts.

The results of the study may be the first step in a paradigm shift in current rescue guidelines. In the course of this year these proposals may be incorporated into the new guidelines issued by the International Commission for Alpine Rescue (ICAR MEDCOM) and the European Resuscitation Council (ERC).
The authors were Dr Les Gordon from Cumbrian Mountain Rescue (UK), Dr Peter Paal from the Medical University of Innsbruck (Austria), Dr John Ellerton from Cumbrian Mountain Rescue (UK), Dr Hermann Brugger from the EURAC Institute of Mountain Emergency Medicine (I), Dr. Giles Peek from Glenfield Hospital Leicester (UK) and Dr Ken Zafren from Stanford University (USA).

Laura Defranceschi | idw - Informationsdienst Wissenschaft
Further information:
http://www.eurac.edu

More articles from Health and Medicine:

nachricht Study suggests possible new target for treating and preventing Alzheimer's
02.12.2016 | Oregon Health & Science University

nachricht The first analysis of Ewing's sarcoma methyloma opens doors to new treatments
01.12.2016 | IDIBELL-Bellvitge Biomedical Research Institute

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Novel silicon etching technique crafts 3-D gradient refractive index micro-optics

A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.

Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...

Im Focus: Quantum Particles Form Droplets

In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.

“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...

Im Focus: MADMAX: Max Planck Institute for Physics takes up axion research

The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.

The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...

Im Focus: Molecules change shape when wet

Broadband rotational spectroscopy unravels structural reshaping of isolated molecules in the gas phase to accommodate water

In two recent publications in the Journal of Chemical Physics and in the Journal of Physical Chemistry Letters, researchers around Melanie Schnell from the Max...

Im Focus: Fraunhofer ISE Develops Highly Compact, High Frequency DC/DC Converter for Aviation

The efficiency of power electronic systems is not solely dependent on electrical efficiency but also on weight, for example, in mobile systems. When the weight of relevant components and devices in airplanes, for instance, is reduced, fuel savings can be achieved and correspondingly greenhouse gas emissions decreased. New materials and components based on gallium nitride (GaN) can help to reduce weight and increase the efficiency. With these new materials, power electronic switches can be operated at higher switching frequency, resulting in higher power density and lower material costs.

Researchers at the Fraunhofer Institute for Solar Energy Systems ISE together with partners have investigated how these materials can be used to make power...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ICTM Conference 2017: Production technology for turbomachine manufacturing of the future

16.11.2016 | Event News

Innovation Day Laser Technology – Laser Additive Manufacturing

01.11.2016 | Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

 
Latest News

UTSA study describes new minimally invasive device to treat cancer and other illnesses

02.12.2016 | Medical Engineering

Plasma-zapping process could yield trans fat-free soybean oil product

02.12.2016 | Agricultural and Forestry Science

What do Netflix, Google and planetary systems have in common?

02.12.2016 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>