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Reanimation nach prähospitalem Herz-Kreislauf-Stillstand

Resuscitation after prehospital cardiovascular arrest

  • Schwerpunkt: Kardiovaskuläre Intensivmedizin
  • Published:
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Zusammenfassung

Der frühestmögliche Zeitpunkt der Einleitung einer effektiven kardiopulmonalen Reanimation (CPR) ist die wichtigste Determinante der Prognose des prähospitalen Herzstillstands. Hierbei wird die Prognose im Wesentlichen durch 2 Parameter definiert: das Überleben bis zur Krankenhausaufnahme und das Überleben bis zur Entlassung („survival-to-discharge“). Im Zusammenhang mit dem prähospitalen Herzstillstand kommt einer frühzeitigen Defibrillation und damit der Verbreitung von (halb)automatischen Defibrillatoren (AED) eine ganz besondere Bedeutung zu. Weitere Aspekte der CPR haben kürzlich vermehrte Aufmerksamkeit erfahren: zum einen eine veränderte Studienlage hinsichtlich des Nutzens von Antiarrhythmika (insbesondere Amiodaron), andererseits die Anwendung von Vasopressin im Rahmen der Reanimation und schließlich die Effektivität einer milden Hypothermie nach prähospitalem Herzstillstand. Diese Aspekte sind Hauptgegenstand der vorliegenden Übersicht, in der auch auf die jüngste Überarbeitung der ILCOR-Leitlinien zur kardiopulmonalen Reanimation eingegangen werden soll, die entsprechende Änderungen der europäischen Leitlinien des ERC (European Resuscitation Council) nach sich gezogen hat.

Abstract

Initiation of effective cardiopulmonary resuscitation (CPR) at the earliest possible moment is the most important determinant of prognosis for prehospital cardiac arrest. The prognosis is essentially defined by two parameters: survival to hospital admission and survival to discharge. In connection with prehospital cardiac arrest, early defibrillation is particularly important, including the widespread availability of (semi)automatic defibrillators. Further aspects of CPR have recently received increased attention: on the one hand, changed study status regarding the use of antiarrhythmic agents (especially amiodarone), on the other hand, administration of vasopressin during resuscitation, and finally, the efficacy of mild hypothermia following prehospital cardiac arrest. These aspects represent the main subject of the present overview, which also addresses the latest revision of the International Liaison Committee on Resuscitation (ILCOR) guidelines on CPR that resulted in corresponding changes in the European Resuscitation Council (ERC) guidelines.

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Authors and Affiliations

  1. Medizinische Klinik III, Kardiologie, Johann Wolfgang Goethe-Universität, Frankfurt a. M.

    T. Klingenheben, A. M. Zeiher & S. Fichtlscherer

  2. Gemeinschaftspraxis Kardiologie, Bonn

    T. Klingenheben

  3. Gemeinschaftspraxis Kardiologie, Alfred-Bucherer-Straße 6, 53115, Bonn

    T. Klingenheben

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  1. T. Klingenheben
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  2. A. M. Zeiher
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  3. S. Fichtlscherer
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Correspondence to T. Klingenheben.

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Klingenheben, T., Zeiher, A.M. & Fichtlscherer, S. Reanimation nach prähospitalem Herz-Kreislauf-Stillstand. Internist 46, 248–255 (2005). https://doi.org/10.1007/s00108-005-1351-7

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  • DOI: https://doi.org/10.1007/s00108-005-1351-7

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