Cerebral Resuscitation by Advanced Cardiac Life Support
1Department of Emergency and Critical Care Medicine, Graduate of School of Medicine, Nippon Medical School
2Department of Critical Care & Traumatology, Nippon Medical School
The introduction of the 2005 American Heart Association Guidelines for Cardiopulmonary resuscitation, emergency care, and public access defibrillation (PAD) has improved the survival rate of patients with cardiopulmonary arrest in Japan. And as for the brain resuscitation, 2 randomized clinical trials explored that induced hypothermia improved outcomes in adults with coma after resuscitation from ventricular fibrillation. Another study also demonstrated improvement of patients' outcome after cardiac arrest with pulseless electrical activity or asystole. In our department, the indications for hypothermia in patients after the recovery of spontaneous circulation are: 1) witnessed arrest, 2) age 15 to 70 years, and 3) stable vital signs. Our series suggests that the outcome of patients with hypothermia after the recovery of spontaneous circulation is better than that of patients without hypothermia. The concept of brain resuscitation is extremely important for favorable outcomes after the resuscitation from cardiac arrest. And in the future the introduction of percutaneous cardiopulmonary support and of hypothermia to resuscitate the brain may help improve the outcomes of patients with cardiac arrest.
日医大医会誌 2008; 4(3), 143-147
cardio-pulmonary resuscitation, guideline 2005, brain resuscitation, hypothermia
Hiroyuki Yokota, MD, Department of Critical Care & Traumatology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan