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 Between Arousal and Inhibition
06.12.2019 | Albert-Ludwigs-Universität Freiburg im Breisgau

nachricht Lung images of twins with asthma add to understanding of the disease
05.12.2019 | University of Western Ontario

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: Developing a digital twin

University of Texas and MIT researchers create virtual UAVs that can predict vehicle health, enable autonomous decision-making

In the not too distant future, we can expect to see our skies filled with unmanned aerial vehicles (UAVs) delivering packages, maybe even people, from location...

Im Focus: The coldest reaction

With ultracold chemistry, researchers get a first look at exactly what happens during a chemical reaction

The coldest chemical reaction in the known universe took place in what appears to be a chaotic mess of lasers. The appearance deceives: Deep within that...

Im Focus: How do scars form? Fascia function as a repository of mobile scar tissue

Abnormal scarring is a serious threat resulting in non-healing chronic wounds or fibrosis. Scars form when fibroblasts, a type of cell of connective tissue, reach wounded skin and deposit plugs of extracellular matrix. Until today, the question about the exact anatomical origin of these fibroblasts has not been answered. In order to find potential ways of influencing the scarring process, the team of Dr. Yuval Rinkevich, Group Leader for Regenerative Biology at the Institute of Lung Biology and Disease at Helmholtz Zentrum München, aimed to finally find an answer. As it was already known that all scars derive from a fibroblast lineage expressing the Engrailed-1 gene - a lineage not only present in skin, but also in fascia - the researchers intentionally tried to understand whether or not fascia might be the origin of fibroblasts.

Fibroblasts kit - ready to heal wounds

Im Focus: McMaster researcher warns plastic pollution in Great Lakes growing concern to ecosystem

Research from a leading international expert on the health of the Great Lakes suggests that the growing intensity and scale of pollution from plastics poses serious risks to human health and will continue to have profound consequences on the ecosystem.

In an article published this month in the Journal of Waste Resources and Recycling, Gail Krantzberg, a professor in the Booth School of Engineering Practice...

Im Focus: Machine learning microscope adapts lighting to improve diagnosis

Prototype microscope teaches itself the best illumination settings for diagnosing malaria

Engineers at Duke University have developed a microscope that adapts its lighting angles, colors and patterns while teaching itself the optimal...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

The Future of Work

03.12.2019 | Event News

First International Conference on Agrophotovoltaics in August 2020

15.11.2019 | Event News

Laser Symposium on Electromobility in Aachen: trends for the mobility revolution

15.11.2019 | Event News

 
Latest News

Developing a digital twin

06.12.2019 | Information Technology

A solution for cleaning up PFAS, one of the world's most intractable pollutants

06.12.2019 | Power and Electrical Engineering

How flowers adapt to their pollinators

06.12.2019 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>