Targeted Temperature Management for Cardiac Arrest with Nonshockable Rhythm – New England Journal of Medicine – October 2019
Analyse de l’article par le Dr Romain Jouffroy, SAMU de Paris,
CHU Necker – Enfants Malades, pour le Comité ACUTE de la SFAR
Le pourcentage global de survie à la sortie de l’hôpital après arrêt cardiaque (AC) est assez stable depuis plusieurs années et évalué à 7,6% dans une récente méta-analyse . Outre les facteurs pronostiques non modifiables liés au terrain et aux délais de découverte (no flow) et de début de réanimation cardiopulmonaire (low flow), la survie globale dépend de l’obtention d’un retour à une activité cardiaque spontanée (RACS), exclusion faite des patients pour lesquels la mise en place d’une assistance circulatoire (eCPR) est retenue, et de la qualité des thérapeutiques instaurées en réanimation. Ces thérapeutiques visent d’une part à traiter la cause de l’AC mais aussi à limiter les lésions, notamment neurologiques irréversibles, induites par les mécanismes d’ischémie-reperfusion.
Dear member of the General Assembly,
Dear NRC Chair,
Dear NRC Contact person,
The ERC Board has taken the decision on Friday to postpone publication of the ERC Guidelines until 2021. This decision has been taken partly because most of us are now consumed with work related to the COVID-19 crisis but we also think there will be little interest in our guidelines so soon after the COVID-19 crisis (assuming it concludes this year).
04 March 2020
Resuscitation Council UK is monitoring closely COVID-19’s impact in the UK.
We are aware of the concerns regarding risk of transmission of COVID-19 (Coronavirus), but wish to emphasise the crucial importance of doing CPR for the person in cardiac arrest.
In the UK, almost 200 people a day will suffer a cardiac arrest out of hospital. When someone has a cardiac arrest, they are not breathing normally and their heart has stopped. With no treatment, this person will die, usually within a few minutes. Early CPR and defibrillation give them their best chance of survival.
The epidemiology and outcome after out-of-hospital cardiac arrest (OHCA) varies across Europe. Following on from EuReCa ONE, the aim of this study was to further explore the incidence of and outcomes from OHCA in Europe and to improve understanding of the role of the bystander.
This prospective, multicentre study involved the collection of registry-based data over a three-month period (1st October 2017 to 31st December 2017). The core study dataset complied with the Utstein-style. Primary outcomes were return of spontaneous circulation (ROSC) and survival to hospital admission. Secondary outcome was survival to hospital discharge.
All 28 countries provided data, covering a total population of 178,879,118. A total of 37,054 OHCA were confirmed, with CPR being started in 25,171 cases. The bystander cardiopulmonary resuscitation (CPR) rate ranged from 13% to 82% between countries (average: 58%). In one third of cases (33%) ROSC was achieved and 8% of patients were discharged from hospital alive. Survival to hospital discharge was higher in patients when a bystander performed CPR with ventilations, compared to compression-only CPR (14% vs. 8% respectively).
In addition to increasing our understanding of the role of bystander CPR within Europe, EuReCa TWO has confirmed large variation in OHCA incidence, characteristics and outcome, and highlighted the extent to which OHCA is a public health burden across Europe. Unexplained variation remains and the EuReCa network has a continuing role to play in improving the quality management of resuscitation.
© 2020 Elsevier B.V. All rights reserved.
For full text go to Resuscitation Journal
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