J Korean Med Assoc.  2013 Jul;56(7):600-608. 10.5124/jkma.2013.56.7.600.

Cardiopulmonary resuscitation update

• Hwang SO

• KMID: 2193050
• DOI: http://doi.org/10.5124/jkma.2013.56.7.600

Abstract

Sudden cardiac arrest is a growing medical issue in developed countries. Annually, more than 25,000 out-of-hospital cardiac arrests (OHCA) occur in Korea. Only 3% of victims with OHCA discharge alive from hospital and less than 1% of them survive neurologically intact. Major changes of recent guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiac care includes modification of basic life support (BLS) sequence from A-B-C to C-A-B, an emphasis on minimally interrupted, high-quality chest compression, the introduction of chest compression-only CPR, and addition of integrated post-cardiac arrest care concept as the fifth chain in the Chain of Survival. Repetition of 2-minutes of CPR, rhythm check, and defibrillation if indicated is recommended as a universal algorithm during BLS. Defibrillation and drug administration including epinephrine should not be delayed to place an advanced airway during CPR. Important interventions during post-cardiac arrest care are comprised of the optimization of ventilation (arterial CO2 tension, 40 to 45 mmHg) and oxygenation (arterial O2 saturation, 94% to 98%), glucose control (blood glucose, 144 to 180 mg/dL), therapeutic hypothermia (body tem-perature, 32degrees C to 34degrees C) for unresponsive patients, and percutaneous coronary intervention for the patient with ST-segment elevation. Systemic approaches to increase public awareness of cardiac arrest and CPR, to spread CPR education to citizen, and to implement public access defibrillation are a prerequisite for improving survival from OHCA in the community. Effective advanced life support and integrated post-cardiac arrest care should be provided to increase neurologically intact survival among the patients resuscitated from cardiac arrest.

Keyword

Cardiopulmonary resuscitation; Heart arrest

MeSH Terms

Cardiopulmonary Resuscitation
Collodion
Death, Sudden, Cardiac
Developed Countries
Emergencies
Epinephrine
Glucose
Heart Arrest
Humans
Hypogonadism
Hypothermia
Korea
Mitochondrial Diseases
Ophthalmoplegia
Out-of-Hospital Cardiac Arrest
Oxygen
Percutaneous Coronary Intervention
Thorax
Ventilation
Collodion
Epinephrine
Glucose
Hypogonadism
Mitochondrial Diseases
Ophthalmoplegia
Oxygen

Figure

• 

  Figure 1 A schematic summary of advanced life support (see text). EGC, electrocardiogram; CPR, cardiopulmonary resuscitation; IV, intravenous; IO, intraosseous.

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