The cardiac arrest centre for the treatment of sudden cardiac arrest due to presumed cardiac cause – aims, function and structure: Position paper of the Association for Acute CardioVascular Care of the European Society of Cardiology (AVCV), European Association of Percutaneous Coronary Interventions (EAPCI), European Heart Rhythm Association (EHRA), European Resuscitation Council (ERC), European Society for Emergency Medicine (EUSEM) and European Society of Intensive Care Medicine (ESICM)

Abstract

Approximately 10% of patients resuscitated from out-of-hospital cardiac arrest survive to hospital discharge. Improved management to improve outcomes is required, and it is proposed that such patients should be preferentially treated in cardiac arrest centres. The minimum requirements of therapy modalities for the cardiac arrest centre are 24/7 availability of an on-site coronary angiography laboratory, an emergency department, an intensive care unit, imaging facilities such as echocardiography, computed tomography and magnetic resonance imaging, and a protocol outlining transfer of selected patients to cardiac arrest centres with additional resources (out-of-hospital cardiac arrest hub hospitals). These hub hospitals are regularly treating a high volume of patients and offer further treatment modalities. This consensus document describes the aims, the minimal requirements for therapeutic modalities and expertise, and the structure, of a cardiac arrest centre. It represents a consensus among the major European medical associations and societies involved in the treatment of out-of-hospital cardiac arrest patients.

European Resuscitation Council and European Society of Intensive Care Medicine Guidelines 2021: Post-resuscitation care

“…An expert consensus paper published by several European organisations including the Association of Acute Cardiovascular Care (ACVA) of the European Society of Cardiology (ESC), the ERC and the ESICM, states that the minimum requirements for a cardiac arrest centre are 24/7 availability of an on-site coronary angiography laboratory, an emergency department, an ICU, imaging facilities, such as echocardiography, CT, and MRI. 16 Based on evidence from a systematic review, ILCOR suggests that wherever possible, adult patients with non-traumatic OHCA cardiac arrest should be cared for in cardiac arrest centres. 17 ACNS…”

“…122,207 An expert consensus paper published by the Association of Acute Cardiovascular Care (ACVA), and many other European organisations including the ERC and ESICM, states that the minimum requirements for a cardiac arrest centre are 24/7 availability of an on-site coronary angiography laboratory, an emergency department, an intensive care unit (ICU), imaging facilities, such as echocardiography, computed tomography, and magnetic resonance imaging. 16 ILCOR suggests that wherever possible, adult patients with nontraumatic OHCA cardiac arrest should be cared for in cardiac arrest centres. 17 This weak recommendation is based on very low certainty evidence from a systematic review that included 21 observational studies.…”

Impact of Cardiac Arrest Centers on the Survival of Patients With Nontraumatic Out‐of‐Hospital Cardiac Arrest: A Systematic Review and Meta‐Analysis

“…CACs are specialized tertiary institutions, conceptually similar to level 1 trauma centers, and are often high‐volume or regionalized centers treating patients with OHCA with the capability to organize postresuscitation care, including 24/7 access to a cardiac catheterization laboratory for coronary angiography and percutaneous coronary intervention (PCI), TTM, extracorporeal membrane oxygenation, and neuroprognostication among other interventions. 12 , 13 , 14 However, although there has been evidence for the effectiveness of each individual intervention in variable settings, 15 , 16 , 17 , 18 , 19 evidence for the benefit of CACs in treating patients with OHCA remain inconclusive. This is in part because CACs, which provide a complex bundle of interventions, have been poorly defined, 10 , 20 and similar institutions described in published literature may range from exhibiting only a few to many of the defining traits of a CAC.…”

Postreanimationsbehandlung

“…Die meisten dieser Zeichen können weniger als 72 h nach ROSC beobachtet werden, ihre Ergebnisse werden jedoch nur zum Zeitpunkt der klinischen Prognoseerstellung gewertet. Eine kürzlich durchgeführte Studie hat gezeigt, dass eine Strategie mit Verwendung von ≥2 Prädiktoren eine 0 % [0-8] FPR aufwies, verglichen mit 7 % [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] der schrittweisen ERC-ESICM-Strategie von 2015 (aufgrund falsch-positiver Ergebnisse für die Lichtreaktion der Pupillen; [413] [184]. Wir empfehlen, bei Patienten mit Postarrestmyoklonien ein EEG aufzuzeichnen, um sowohl eine epileptiforme Aktivität als auch Anzeichen für eine mögliche Genesung zu erkennen.…”

“…In einem von der Association of Acute Cardiovascular Care (ACVA) und vielen anderen europäischen Organisationen, einschließlich ERC und ESICM, veröffentlichten Expertenkonsenspapier werden die Mindestanforderungen für ein Cardiac Arrest Center festgelegt. Dazu gehören ein rund um die Uhr verfügbares Herzkatheterlabor mit der Möglichkeit der unmittelbaren Primär-PCI, eine Notaufnahme, eine Intensivstation (ICU) und bildgebende Verfahren wie Echokardiographie, Computertomographie und Magnetresonanztomographie [17].…”