Comparative Hemodynamics During Open vs Closed Cardiac Resuscitation

European Journal of Anaesthesiology

Böttiger

et al. 2023

INTRODUCTION Cardiac arrest in the operating room is a rare but potentially life-threatening event with mortality rates of more than 50%. Contributing factors are often known, and the event is recognised rapidly as patients are usually under full monitoring. This guideline covers the perioperative period and is complementary to the European Resuscitation Council (ERC) guidelines. MATERIAL AND METHODS The European Society of Anaesthesiology and Intensive Care and the European Society for Trauma and Emergency Surgery jointly nominated a panel of experts to develop guidelines for the recognition, treatment and prevention of cardiac arrest in the perioperative period. A literature search was conducted in MEDLINE, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials. All searches were restricted to publications from 1980 to 2019 inclusive and to the English, French, Italian and Spanish languages. The authors also contributed individual, independent literature searches. RESULTS This guideline contains background information and recommendation for the treatment of cardiac arrest in the operating room environment, and addresses controversial topics such as open chest cardiac massage (OCCM), resuscitative endovascular balloon occlusion (REBOA) and resuscitative thoracotomy, pericardiocentesis, needle decompression and thoracostomy. CONCLUSION Successful prevention and management of cardiac arrest during anaesthesia and surgery requires anticipation, early recognition and a clear treatment plan. The ready availability of expert staff and equipment must also be taken into consideration. Success not only depends on medical knowledge, technical skills and a well organised team using crew resource management but also on an institutional safety culture embedded in everyday practice through continuous education, training and multidisciplinary co-operation.

Section: Resultsmentioning

confidence: 99%

Section: Identification Of Cardiac Arrestmentioning

confidence: 99%

Cardiac arrest in the perioperative period: a consensus guideline for identification, treatment, and prevention from the European Society of Anaesthesiology and Intensive Care and the European Society for Trauma and Emergency Surgery

Hinkelbein

European Journal of Anaesthesiology

Böttiger

et al. 2023

“…When OCCM is employed within the first minutes of cardiac arrest, hospital discharge rates of up to 50% were achieved [78]. The efficiency of Closed chest compressions (CCC) was questioned [79] and animal experimental research into the topic revealed that under OCCM cardiac output, cardiac index, coronary perfusion pressure (corPP), carotid artery flow and cerebral perfusion were significantly better than under closed chest compressions [80][81][82][83][84][85][86][87][88][89]. This correlates with significantly higher ROSC rates, long term survival, less cerebral tissue damage and better neurological function in survivors [47,80,81,[89][90][91][92].…”

Section: Closed Chest Compression and Open Chest Cardiac Massagementioning

confidence: 99%

Cardiac arrest in the perioperative period: a consensus guideline for identification, treatment, and prevention from the European Society of Anaesthesiology and Intensive Care and the European Society for Trauma and Emergency Surgery

Hinkelbein

Eur J Trauma Emerg Surg

Böttiger

et al. 2023

Introduction Cardiac arrest in the operating room is a rare but potentially life-threatening event with mortality rates of more than 50%. Contributing factors are often known, and the event is recognised rapidly as patients are usually under full monitoring. This guideline covers the perioperative period and is complementary to the European Resuscitation Council guidelines. Material And Methods The European Society of Anaesthesiology and Intensive Care and the European Society for Trauma and Emergency Surgery jointly nominated a panel of experts to develop guidelines for the recognition, treatment, and prevention of cardiac arrest in the perioperative period. A literature search was conducted in MEDLINE, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials. All searches were restricted to publications from 1980 to 2019 inclusive and to the English, French, Italian and Spanish languages. The authors also contributed individual, independent literature searches. Results This guideline contains background information and recommendation for the treatment of cardiac arrest in the operating room environment, and addresses controversial topics such as open chest cardiac massage, resuscitative endovascular balloon occlusion and resuscitative thoracotomy, pericardiocentesis, needle decompression, and thoracostomy. Conclusions Successful prevention and management of cardiac arrest during anaesthesia and surgery requires anticipation, early recognition, and a clear treatment plan. The ready availability of expert staff and equipment must also be taken into consideration. Success not only depends on medical knowledge, technical skills and a well-organised team using crew resource management, but also on an institutional safety culture embedded in everyday practice through continuous education, training, and multidisciplinary co-operation.

“…Effectiveness of both resuscitation methods was found comparable in a number of experimental studies on animal models. The first studies come from the early 1960s and showed significantly higher blood flow in the carotid arteries during OCCM [6,7].…”

Section: Body Of the Articlementioning

confidence: 99%

Folia Medica Cracoviensia

Szpor

Uchańska

2021

Cardiopulmonary resuscitation is one of the most studied procedures in medicine. Over the years, despite numerous scientific studies, changes in guidelines, refining algorithms, expanding the availability of resuscitation equipment and educating the public, it has not been possible to improve the results of treatment of patients after cardiac arrest. Only 10% of them survive until hospital discharge. There is a well-tested medical procedure, wide application of which could improve results of resuscitation. This procedure is open chest cardiac massage (OCCM). OCCM is not a new technique, its use dates back to the nineteenth century, now it is reserved for patients sustaining trauma and those after surgical procedures. A number of experimental and clinical studies have proven its advantage over the currently preferred indirect massage (CCCM) also in the group of nontraumatic patients. Of course, OCCM is an invasive method with a number of possible complications accompanying surgical procedures, and its wide implementation would require a long-term training program, but it seems that it could be an impulse that would significantly improve survival in this group of patients.