European Resuscitation Council Guidelines for Resuscitation 2010 Section 4. Adult advanced life support

Deakin, Charles D.; Nolan, Jerry P.; Soar, Jasmeet; Sunde, Kjetil; Koster, Rudolph W.; Smith, Gary B.; Perkins, Gavin D.

doi:10.1016/j.resuscitation.2010.08.017

Cited by 1,308 publications

(781 citation statements)

References 809 publications

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“…Epinephrine is recommended in the advanced cardiac life support (ACLS) guidelines for use in adult cardiac arrest,[11,12] and has been used in cardiopulmonary resuscitation since 1896. [13] It is a non-selective alpha and beta adrenergic agonist, and its value in resuscitation is due largely to the alpha-1 receptor mediated vasoconstrictive activity.…”

Section: Introductionmentioning

confidence: 99%

Epinephrine in out-of-hospital cardiac arrest:A critical review

Reardon¹,

Magee²

2013

World Journal of Emergency Medicine

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BACKGROUND:Epinephrine is recommended in advanced cardiac life support guidelines for use in adult cardiac arrest, and has been used in cardiopulmonary resuscitation since 1896. Yet, despite its long time use and incorporation into guidelines, epinephrine suffers from a paucity of evidence regarding its influence on survival. This critical review was conducted to address the knowledge deficit regarding epinephrine in out-of-hospital cardiac arrest and its effect on return of spontaneous circulation, survival to hospital discharge, and neurological performance.METHODS:The EMBASE and MEDLINE (through the Pubmed interface) databases, and the Cochrane library were searched with the key words “epinephrine”, “cardiac arrest” and variations of these terms. Original research studies concerning epinephrine use in adult, out-of-hospital cardiac arrest were selected for further review.RESULTS:The search yielded nine eligible studies based on inclusion criteria. This includes five prospective cohort studies, one retrospective cohort study, one survival analysis, one case control study, and one RCT. The evidence clearly establishes an association between epinephrine and increased return of spontaneous circulation, the data were conflicting concerning survival to hospital discharge and neurological outcome.CONCLUSIONS:The results of this review exhibit the paucity of evidence regarding the use of epinephrine in out of hospital cardiac arrest. There is currently insufficient evidence to support or reject its administration during resuscitation. Larger sample, placebo controlled, double blind, randomized control trials need to be performed to definitively establish the effect of epinephrine on both survival to hospital discharge and the neurological outcomes of treated patients.

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Section: Introductionmentioning

confidence: 99%

Epinephrine in out-of-hospital cardiac arrest:A critical review

Reardon¹,

Magee²

2013

World Journal of Emergency Medicine

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“…1 Although not all cases of cardiac arrest should undergo fibrinolysis in the field, the ERC 2010 guidelines suggest it should be considered when pulmonary embolism is highly suspected in the field and proven in hospital. 1 The TROICA-study 7 was designed to assess safety and efficiency of prehospital thrombolytic therapy with tenecteplase versus placebo in cardiac arrest, and is one of the largest trials, with 1,050 enrolled patients. The results did not show an improvement in 30-day survival for all patients, but cases with pulmonary embolism did benefit from early thrombolysis.…”

Section: Discussionmentioning

confidence: 99%

“…1 In order to save the lives of those affected, the cause needs to be identified as soon as possible in order to start the targeted therapy. This process begins with the advanced cardiac life support (ACLS).…”

Section: Introductionmentioning

confidence: 99%

“…The European Resuscitation Council (ERC) 2010 guidelines do not recommend this in all cases of cardiac arrest, however thrombolytics can be considered when pulmonary embolism is highly suspected or proven in order to improve survival and neurological outcome of patients. 1 In addition to thrombolysis, an active mechanical guide wire fragmentation of the thrombus with a flexible endovascular wire is effective in improving pulmonary perfusion and clinical outcome. 2 In OHCA, optimal CPR is vital for the survival of the patients.…”

Section: Introductionmentioning

confidence: 99%

“…It can be used during further diagnositic testing such as computed tomography (CT). 1,5 Early CT in these situations has demonstrated improved survival rates. 6 …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Use of computed tomography and mechanical CPR in cardiac arrest to confirm pulmonary embolism: a case study

Schubert¹,

Kanz

Linsenmaier

et al. 2015

CJEM

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Precise therapeutic decision-making is vital in managing out-of-hospital cardiac arrest. We present an interesting approach where suspected pulmonary embolism could be confirmed by early computed tomography in cardiac arrest. Chest compressions were performed automatically by mechanical devices also during the acquisition of computed tomography data and subsequent thrombolysis. RÉSUMÉLa précision des décisions relatives au traitement est d'importance « vitale » dans la prise en charge des arrêts cardiaques extrahospitaliers. Sera présentée ici une intervention intéressante, qui a permis de confirmer, par une tomodensitométrie (TDM) précoce, une embolie pulmonaire présumée chez une patiente en état d'arrêt cardiaque. Les compressions thoraciques, réalisées automatiquement par un appareil mécanique se sont poursuivies durant l'acquisition des données de la TDM et le traitement thrombolytique qui s'en est suivi.

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