CEASE: A Guide for Clinicians on How to Stop Resuscitation Efforts

Torke, Alexia M.; Bledsoe, Patricia; Wocial, Lucia D.; Bosslet, Gabriel T.; Helft, Paul R.

doi:10.1513/annalsats.201412-552ps

Cited by 12 publications

(8 citation statements)

References 46 publications

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“…Normothermic CPR can provide ∼30% of pre-arrest cardiac output (CO) (Wik et al, 1996;Sunde et al, 1998;Pytte et al, 2006) but is usually considered discontinued after 20-30 min if the return of spontaneous circulation is not achieved, as these patients show poor clinical outcome (Torke et al, 2015;Perkins et al, 2015a,b). Preclinical studies (Wik et al, 1996;Gervais et al, 1997;Schwarz et al, 2002;Tomte et al, 2010;Welbourn and Efstathiou, 2018) also support this clinical notion, but the maximum duration of CPR in normothermic patients has so far not been determined (Welbourn and Efstathiou, 2018).…”

Section: Introductionmentioning

confidence: 99%

Study of the Effects of 3 h of Continuous Cardiopulmonary Resuscitation at 27°C on Global Oxygen Transport and Organ Blood Flow

et al. 2020

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Aims: Complete restitution of neurologic function after 6 h of pre-hospital resuscitation and in-hospital rewarming has been reported in accidental hypothermia patients with cardiac arrest (CA). However, the level of restitution of circulatory function during longlasting hypothermic cardiopulmonary resuscitation (CPR) remains largely unknown. We compared the effects of CPR in replacing spontaneous circulation during 3 h at 27 • C vs. 45 min at normothermia by determining hemodynamics, global oxygen transport (DO 2), oxygen uptake (VO 2), and organ blood flow. Methods: Anesthetized pigs (n = 7) were immersion cooled to CA at 27 • C. Predetermined variables were compared: (1) Before cooling, during cooling to 27 • C with spontaneous circulation, after CA and subsequent continuous CPR (n = 7), vs. (2) before CA and during 45 min CPR in normothermic pigs (n = 4). Results: When compared to corresponding values during spontaneous circulation at 38 • C: (1) After 15 min of CPR at 27 • C, cardiac output (CO) was reduced by 74%, mean arterial pressure (MAP) by 63%, DO 2 by 47%, but organ blood flow was unaltered. Continuous CPR for 3 h maintained these variables largely unaltered except for significant reduction in blood flow to the heart and brain after 3 h, to the kidneys after 1 h, to the liver after 2 h, and to the stomach and small intestine after 3 h. (2) After normothermic CPR for 15 min, CO was reduced by 71%, MAP by 54%, and DO 2 by 63%. After 45 min, hemodynamic function had deteriorated significantly, organ blood flow was undetectable, serum lactate increased by a factor of 12, and mixed venous O 2 content was reduced to 18%. Conclusion: The level to which CPR can replace CO and MAP during spontaneous circulation at normothermia was not affected by reduction in core temperature in our

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Section: Introductionmentioning

confidence: 99%

Study of the Effects of 3 h of Continuous Cardiopulmonary Resuscitation at 27°C on Global Oxygen Transport and Organ Blood Flow

et al. 2020

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“…In another article, statistics revealed that CPR of 20 minutes had a lower survival rate compared to 20–30 minutes and >30 minutes in humans in an out of hospital setting 13 . Prolonged CPR can lead to better survival rates if the rescuers adhere to the evidence‐based CPR guidelines 14 . If the generation of adequate pulses from effective chest compression is achieved and a PE′CO 2 of >15 mm Hg is reached, this could favour the ROSC even after an extended period 15 …”

Section: Discussionmentioning

confidence: 99%

“…13 Prolonged CPR can lead to better survival rates if the rescuers adhere to the evidence-based CPR guidelines. 14 If the generation of adequate pulses from effective chest compression is achieved and a PE′CO 2 of >15 mm Hg is reached, this could favour the ROSC even after an extended period. 15 Capnography has gained favour as an essential monitoring tool during CPR not only to confirm tracheal intubation but also to govern CPR efforts.…”

Section: Discussionmentioning

confidence: 99%

Successful prolonged cardiopulmonary resuscitation in a Siamese cat: A case of post‐cardiac arrest concerns

Grace

Nagel²,

Zeiler

2021

Vet Record Case Reports

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A 4.5‐year‐old male neutered Siamese cat was admitted to referral hospital for medical work‐up of chronic anorexia and emesis. No severe abnormalities were detected on routine blood work; however thickened gastric wall and small intestines were noted on abdominal ultrasonography. The cat was premedicated with buprenorphine followed by a diazepam‐propofol co‐induction. Endotracheal intubation was performed, and anaesthesia was maintained using isoflurane in oxygen for endoscopic investigation of the thickened gastric wall and biopsies retrieval. During the anaesthetic recovery, the animal went into cardiopulmonary arrest. Successful ROSC (return of spontaneous circulation) was achieved at approximate 40 minutes (prolonged) post‐arrest, and the animal had a survived event (ROSC > 20 minutes). However, failure to identify the inciting cause of the CPA and laxity in the post‐cardiac arrest care resulted in rearrest of the cat, 77 hours after the initial ROSC with no success of a second ROSC.

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“…Von allen 277 Neugeborenen starben 69 % vor der letzten Nachuntersuchung, 18 % überlebten mit mittelschwerer bis schwerer Beeinträchtigung der neurologischen Entwicklung und 11 % überlebten ohne mittelschwere oder schwere Beeinträchtigung der neurologischen Entwicklung (bei 2 % lagen keine Follow-up-Daten vor) [ 1 ]. Für die Entscheidung zum Fortführen einer Reanimation kann es hilfreich sein, klinische Faktoren, die Effektivität der Reanimationsmaßnahmen und die Ansichten der Teammitglieder zu berücksichtigen [ 370 ].…”

Section: Wissenschaftliche Grundlagen Auf Deren Basis Die Empfehlungen Für Die Praxis Zur Versorgung Und Reanimation Des Neugeborenen Berunclassified

Versorgung und Reanimation des Neugeborenen nach der Geburt

Madar

Roehr

Ainsworth³

et al. 2021

Notfall Rettungsmed

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Die vorliegenden Leitlinien des European Resuscitation Council zur Versorgung und Reanimation des Neugeborenen nach der Geburt beruhen auf dem International Liaison Committee on Resuscitation (ILCOR) 2020 Consensus on Science and Treatment Recommendations (CoSTR) for Neonatal Life Support (NLS). Sie beinhalten Empfehlungen zur Versorgung und Reanimation des reifen Neugeborenen und zur Stabilisierung des Frühgeborenen. Sie umfassen den aktualisierten Algorithmus zur Reanimation des Neugeborenen, die Vorbereitungen vor der Versorgung eines Neugeborenen, die Themen Training und Ausbildung, Wärmemanagement, Empfehlungen zum Abnabeln, die initiale Beurteilung und Einschätzung des Neugeborenen, das Atemwegsmanagement, inklusive einer Notfallbeatmung, und die Kreislaufunterstützung im Falle einer vollen Reanimation. Darüber hinaus finden sich Empfehlungen zur Kommunikation mit den Eltern und ethische Überlegungen, in welchen Situationen erwogen werden soll, auf Reanimationsmaßnahmen zu verzichten bzw. Reanimationsmaßnahmen nicht fortzuführen. Zusatzmaterial online Zusätzliche Informationen sind in der Online-Version dieses Artikels (10.1007/s10049-021-00894-w) enthalten.

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CEASE: A Guide for Clinicians on How to Stop Resuscitation Efforts

Cited by 12 publications

References 46 publications

Study of the Effects of 3 h of Continuous Cardiopulmonary Resuscitation at 27°C on Global Oxygen Transport and Organ Blood Flow

Study of the Effects of 3 h of Continuous Cardiopulmonary Resuscitation at 27°C on Global Oxygen Transport and Organ Blood Flow

Successful prolonged cardiopulmonary resuscitation in a Siamese cat: A case of post‐cardiac arrest concerns

Versorgung und Reanimation des Neugeborenen nach der Geburt

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