Future directions for resuscitation research. V. Ultra-advanced life support

Tisherman, Samuel A.; Vandevelde, Karel; Šafář, Peter; Morioka, Tohru; Obrist, Walter D.; Corne, Luc; Buckman, Robert F.; Rubertsson, Sten; Stephenson, Hugh E.; Grenvik, Åke; White, Robert J.

doi:10.1016/s0300-9572(96)01065-9

Cited by 36 publications

(12 citation statements)

References 70 publications

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“…6) Appreciation of the value of controlled CPCR outcome studies in clinically relevant models of large animals (dogs, pigs), and the limitations of randomized clinical outcome studies (lessons learned from BRCT). 19,28-31 7) When brief attempts at closed-chest CPR-ALS have failed to achieve ROSC, to consider switching to ultra-advanced life support measures, 35 such as open-chest CPR-even out-of-hospital 36 and certainly in the ED-or emergency cardiopulmonary bypass (CPB). 37,38 The Belgian groups by Martens and Idrissi have tried switching to open-chest CPR out-of-hospital when attempts at closed-chest CPR-ALS have failed.…”

Section: The Futurementioning

confidence: 99%

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On the Future of Reanimatology*

Šafář

2000

Academic Emergency Medicine

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Abstract. This article is adapted from a presentation given at the 1999 SAEM annual meeting by Dr. Peter Safar. Dr. Safar has been involved in resuscitation research for 44 years, and is a distinguished professor and past initiating chairman of the Department of Anesthesiology and Critical Care Medicine at the University of Pittsburgh. He is the founder and director of the Safar Center for Resuscitation Research at the University of Pittsburgh, and has been the research mentor of many critical care and emergency medicine research fellows. Here he presents a brief history of past accomplishments, recent findings, and future potentials for resuscitation research. Additional advances in resuscitation, from acute terminal states and clinical death, will build upon the lessons learned from the history of reanimatology, including optimal delivery by emergency medical services of already documented cardiopulmonary cerebral resuscitation, basic-advanced-prolonged life support, and future scientific breakthroughs. Current controversies, such as how to best educate the public in life-supporting first aid, how to restore normotensive spontaneous circulation after cardiac arrest, how to rapidly induce mild hypothermia for cerebral protection, and how to minimize secondary insult after cerebral ischemia, are discussed, and must be resolved if advances are to be made. Dr. Safar also summarizes future technologies already under preliminary investigation, such as ultra-advanced life support for reversing prolonged cardiac arrest, extending the ''golden hour'' of shock tolerance, and suspended animation for delayed resuscitation.

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Section: The Futurementioning

confidence: 99%

“…The first limiting obstacle is external CPR-ALS-resistant hearts that might be saved by ultra-ALS. 35 Artificial circulation for several hours might sometimes be lifesaving. The pathophysiology of protracted heart failure that resists ROSC attempts remains to be investigated.…”

Section: The Futurementioning

confidence: 99%

On the Future of Reanimatology*

Šafář

2000

Academic Emergency Medicine

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“…[1][2][3][4][5][6][7][8][9][10] The work of Rubertsson et al 1 11 in an animal model, demonstrated the better systemic perfusion achieved with OCCC, especially during the important relaxation phase when coronary perfusion occurs. On human cardiac arrest, Boczar et al 2 found a significant diVerence between the coronary perfusion pressure achieved with closed chest (7.3 +/− 5.7 mm Hg) and open chest (32.6 +/− 17.8 mm Hg) cardiac compressions.…”

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confidence: 97%

Physiological variables during open chest cardiopulmonary resuscitation: results from a small series

Calinas-Correia

Phair²

2000

Emergency Medicine Journal

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“…While presumably quite stressful to nonsurgeons, incising the anterior abdominal wall to access the peritoneal cavity is technically simple and is a procedure that might be appropriate for telementoring. Nonphysicians have anecdotally performed this procedure successfully, 5 although there are no data on their performance compared with that of trained operators and/or on their degree of stress. A future adjunct may also be the introduction of expanding foams, which might lessen the size of abdominal opening required in such a prehospital setting.…”

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confidence: 99%