European Resuscitation Council Guidelines for Resuscitation 2005

Nolan, Jerry P.; Deakin, Charles D.; Soar, Jasmeet; Böttiger, Bernd W.; Smith, Gary B.

doi:10.1016/j.resuscitation.2005.10.009

Cited by 771 publications

(399 citation statements)

References 387 publications

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“…Upon admission or in the fi rst 24 hours, such an event worsens prognosis, although it remains unclear if this change is an indicator of severity of neurological disease or the determinant of clinical worsening 16,19 . Thus, in the presence of acute brain injury, diffuse or not, after CA or after any other etiology, fever must be aggressively avoided 20 in the fi rst 72 hours of evolution.…”

Section: Temperaturementioning

confidence: 99%

“…Hypoxemia may worsen prognosis especially due to a higher risk of a second episode of CA 20 . Therefore, PaO 2 must remain above 65 mmHg and the SaO 2 higher than 92%.…”

Section: Ventilationmentioning

confidence: 99%

“…These alterations are pronounced in patients who die in the fi rst two days 31 . Anticoagulation may contribute to decrease the risk of another CA, more so after myocardial infraction or pulmonary embolism 20 . However, this theoretical benefi t was not documented in in vivo clinical studies.…”

Section: Anticoagulationmentioning

confidence: 99%

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Abordagem do paciente reanimado, pós-parada cardiorrespiratória

Pereira¹

2008

Rev. bras. ter. intensiva

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SUMMARY BACKGROUND AND OBJECTIVES:Out-of-hospital cardiac arrest is a major cause of death with survival rates as low as 5% to 35%. A large number of patients who survive resuscitation will face significant neurological damage, as a result of the ischemia that occurs both during cardiac arrest and reperfusion. However understanding of the mechanisms responsible for brain damage has not resulted in prognostic improvement. Therapeutic hypothermia after resuscitation may be a valid option associated to reduction of neurological damage. The purpose of this study was to review scientific evidence related to a therapy for patients resuscitated from cardiac arrest. CONTENTS: Description and analysis of the main risk factors associated with neurological damage after resuscitation from cardiac arrest as well as prognostic criteria was carried out. A non-systematic search was conducted in the PubMed data base for papers on a therapeutic approach for patients resuscitated from cardiac arrest. Bibliographic references of reviewed papers were also analyzed. Practical rules were drafted for such an approach.

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Section: Temperaturementioning

confidence: 99%

“…Hypoxemia may worsen prognosis especially due to a higher risk of a second episode of CA 20 . Therefore, PaO 2 must remain above 65 mmHg and the SaO 2 higher than 92%.…”

Section: Ventilationmentioning

confidence: 99%

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Abordagem do paciente reanimado, pós-parada cardiorrespiratória

Pereira¹

2008

Rev. bras. ter. intensiva

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“…Therapeutic hypothermia has been shown to improve outcome after cardiac arrest [3], consequently the European Resuscitation Council and American Heart Association guidelines [4,5] recommend the use of hypothermia in these patients. Hypothermia is also thought to improve neurological outcome after neonatal birth asphyxia [6].…”

Section: Introductionmentioning

confidence: 99%

European society of intensive care medicine study of therapeutic hypothermia (32-35°C) for intracranial pressure reduction after traumatic brain injury (the Eurotherm3235Trial)

Andrews

Sinclair

Battison

et al. 2011

Trials

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BackgroundTraumatic brain injury is a major cause of death and severe disability worldwide with 1,000,000 hospital admissions per annum throughout the European Union.Therapeutic hypothermia to reduce intracranial hypertension may improve patient outcome but key issues are length of hypothermia treatment and speed of re-warming. A recent meta-analysis showed improved outcome when hypothermia was continued for between 48 hours and 5 days and patients were re-warmed slowly (1°C/4 hours). Previous experience with cooling also appears to be important if complications, which may outweigh the benefits of hypothermia, are to be avoided.Methods/designThis is a pragmatic, multi-centre randomised controlled trial examining the effects of hypothermia 32-35°C, titrated to reduce intracranial pressure <20 mmHg, on morbidity and mortality 6 months after traumatic brain injury. The study aims to recruit 1800 patients over 41 months. Enrolment started in April 2010.Participants are randomised to either standard care or standard care with titrated therapeutic hypothermia. Hypothermia is initiated with 20-30 ml/kg of intravenous, refrigerated 0.9% saline and maintained using each centre's usual cooling technique. There is a guideline for detection and treatment of shivering in the intervention group. Hypothermia is maintained for at least 48 hours in the treatment group and continued for as long as is necessary to maintain intracranial pressure <20 mmHg. Intracranial hypertension is defined as an intracranial pressure >20 mmHg in accordance with the Brain Trauma Foundation Guidelines, 2007.DiscussionThe Eurotherm3235Trial is the most important clinical trial in critical care ever conceived by European intensive care medicine, because it was launched and funded by the European Society of Intensive Care Medicine and will be the largest non-commercial randomised controlled trial due to the substantial number of centres required to deliver the target number of patients. It represents a new and fundamental step for intensive care medicine in Europe. Recruitment will continue until January 2013 and interested clinicians from intensive care units worldwide can still join this important collaboration by contacting the Trial Coordinating Team via the trial website http://www.eurotherm3235trial.eu.Trial registrationCurrent Controlled Trials ISRCTN34555414

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“…In 2005 the European Resuscitation Council (ERC) Guidelines for Advanced Life Support included less than three pages of text on post-resuscitation care [1]. Since 2005, the management of post-cardiac arrest patients has achieved a much higher profile within the specialty of critical care medicine, a fact that is reflected by the substantial increase in the number of studies published in this field.…”

mentioning

confidence: 99%