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 Routing gene therapy directly into the brain
07.12.2017 | Boston Children's Hospital

nachricht New Hope for Cancer Therapies: Targeted Monitoring may help Improve Tumor Treatment
01.12.2017 | Berliner Institut für Gesundheitsforschung / Berlin Institute of Health (BIH)

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: Scientists channel graphene to understand filtration and ion transport into cells

Tiny pores at a cell's entryway act as miniature bouncers, letting in some electrically charged atoms--ions--but blocking others. Operating as exquisitely sensitive filters, these "ion channels" play a critical role in biological functions such as muscle contraction and the firing of brain cells.

To rapidly transport the right ions through the cell membrane, the tiny channels rely on a complex interplay between the ions and surrounding molecules,...

Im Focus: Towards data storage at the single molecule level

The miniaturization of the current technology of storage media is hindered by fundamental limits of quantum mechanics. A new approach consists in using so-called spin-crossover molecules as the smallest possible storage unit. Similar to normal hard drives, these special molecules can save information via their magnetic state. A research team from Kiel University has now managed to successfully place a new class of spin-crossover molecules onto a surface and to improve the molecule’s storage capacity. The storage density of conventional hard drives could therefore theoretically be increased by more than one hundred fold. The study has been published in the scientific journal Nano Letters.

Over the past few years, the building blocks of storage media have gotten ever smaller. But further miniaturization of the current technology is hindered by...

Im Focus: Successful Mechanical Testing of Nanowires

With innovative experiments, researchers at the Helmholtz-Zentrums Geesthacht and the Technical University Hamburg unravel why tiny metallic structures are extremely strong

Light-weight and simultaneously strong – porous metallic nanomaterials promise interesting applications as, for instance, for future aeroplanes with enhanced...

Im Focus: Virtual Reality for Bacteria

An interdisciplinary group of researchers interfaced individual bacteria with a computer to build a hybrid bio-digital circuit - Study published in Nature Communications

Scientists at the Institute of Science and Technology Austria (IST Austria) have managed to control the behavior of individual bacteria by connecting them to a...

Im Focus: A space-time sensor for light-matter interactions

Physicists in the Laboratory for Attosecond Physics (run jointly by LMU Munich and the Max Planck Institute for Quantum Optics) have developed an attosecond electron microscope that allows them to visualize the dispersion of light in time and space, and observe the motions of electrons in atoms.

The most basic of all physical interactions in nature is that between light and matter. This interaction takes place in attosecond times (i.e. billionths of a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

See, understand and experience the work of the future

11.12.2017 | Event News

Innovative strategies to tackle parasitic worms

08.12.2017 | Event News

AKL’18: The opportunities and challenges of digitalization in the laser industry

07.12.2017 | Event News

 
Latest News

PhoxTroT: Optical Interconnect Technologies Revolutionized Data Centers and HPC Systems

11.12.2017 | Information Technology

Large-scale battery storage system in field trial

11.12.2017 | Power and Electrical Engineering

See, understand and experience the work of the future

11.12.2017 | Event News

VideoLinks
B2B-VideoLinks
More VideoLinks >>>