Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020672 (hypothermia)
 17,327 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This 2010 is a memorial year for CPR, as in 1960 closed chest cardiac massage was first introduced in clinical setting. Jude, Kouwenhoven are the pioneer of this method. However, Prof. Peter Safar was also distinguished pioneer of articial respiration and airway management. Manual chest compression is not efficient to maintain oxygenation and impossible to airway patent. Applying both respiration by mouth-to-mouth breathing and closed chest cardiac massage, it started the new era of CPR. CPR has been expanded to every countries, however, it has not been successful to obtain a good survival rate in out -of-hospital cardiac arrest. BLS is the most important to increase the survival rate. It is the problem how to recover brain function after cardiac arrest then followed with recovery of spontaneous circulation. Brain oriented resuscitation is the target for CPR. Chain of survival is still very useful to treat cardiac arrest. Post cardiac arrest syndrome should be well recognized and hypothermia therapy is introduced as one of the best treatment.
 ...
PMID:[Historical review from beginning of CPR to CPCR (cardiopulmonary resuscitation to cardiopulmonary-cerebral resuscitation)]. 2159 10

Key changes in Guideline 2010 by Japanese Resuscitation Council were described and the reasons of the change were explained based on 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care with Treatment Recommendations. In BLS, the value of chest compression was further emphasized and it became an initial skill of CPR In ALS, post resuscitation care was systemized by incorporating hypothermia, PCI, and other diagnostic and therapeutic modalities. Indication of hypothermia was further expanded to non-VF categories. Use of AED was expanded to infant. Education, Implementation and Teams were newly included as a chapter to promote the knowledge and skill of resuscitation science into the society.
 ...
PMID:[New evidences in the 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care with Treatment Recommendations]. 2159 11

Recently published evidence has challenged some protocols related to oxygenation, ventilation, and airway management for out-of-hospital cardiac arrest. Interrupting chest compressions to attempt airway intervention in the early stages of OHCA in adults may worsen patient outcomes. The change of BLS algorithms from ABC to CAB was recommended by the AHA in 2010. Passive insufflation of oxygen into a patent airway may provide oxygenation in the early stages of cardiac arrest. Various alternatives to tracheal intubation or bag-mask ventilation have been trialled for prehospital airway management. Simple methods of airway management are associated with similar outcomes as tracheal intubation in patients with OHCA. The insertion of a laryngeal mask airway is probably associated with worse neurologically intact survival rates in comparison with other methods of airway management. Hyperoxemia following OHCA may have a deleterious effect on the neurological recovery of patients. Extracorporeal oxygenation techniques have been utilized by specialized centers, though their use in OHCA remains controversial. Chest hyperinflation and positive airway pressure may have a negative impact on hemodynamics during resuscitation and should be avoided. Dyscarbia in the postresuscitation period is relatively common, mainly in association with therapeutic hypothermia, and may worsen neurological outcome.
...
PMID:Oxygenation, ventilation, and airway management in out-of-hospital cardiac arrest: a review. 2472 81