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Ventilation during cardiopulmonary resuscitation

Ventilation zur kardiopulmonalen Reanimation

  • Chapter
Die Notfalltherapie bei akutem Kreislaufstillstand

  • 39 Accesses

Summary

In August 2000, the American Heart Association and the European Resuscitation Council published the conclusions of the International Guidelines 2000 Conference on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care; the result is both the new recommendations and in-depth review. During the entire process, scientists and resuscitation councils from all over the world participated; with participants from the United States comprising ~60%, and scientists from outside of the United States comprising ~40%. In order to ensure that CPR recommendations are not dominated by a given nation or resuscitation council, most topics were reviewed and interpretated by two scientists from the United States and two scientists from outside of the United States. Accordingly, changes in these new CPR recommendations are the result of evidence-based review by worldwide experts. According to the authors, the most important changes in the recommendations concerning ventilation during CPR are 500 ml instead of 800–1200 ml tidal volume during bag-valve-mask ventilation (FiO2 > 0.4) of a patient with an unprotected airway, verifying correct endotracheal intubation with capnography and an esophageal detector, and recommending alternative airway devices such as the laryngeal mask and the combitube in case of impossible tracheal intubation.

Zusammenfassung

Ende August 2000 haben die American Heart Association und das European Resuscitation Council gemeinsam die internationalen Richtlinien zur kardiopulmonalen Reanimation (CPR) veröffentlicht; das Ergebnis sind CPR-Richtlinien, die gleichzeitig ein umfassendes Nachschlagewerk darstellen. An dem gesamten Prozess waren Wissenschaftler und Wiederbelebungsgesellschaften aus aller Welt beteiligt; wobei Teilnehmer aus den USA etwa 60%, und Teilnehmer von außerhalb der USA etwa 40% ausmachten. Um ein Übergewicht eines Landes oder einer Wiederbelebungsgesellschaft zu vermeiden, wurden alle Themen von jeweils zwei Wissenschaftlern aus den USA und von außerhalb der USA untersucht und bewertet. Auf diese Weise kann man sagen, dass Änderungen in den neuen CPR-Richtlinien anhand dieses „evidence-based“ Konzepts durch Experten aus aller Welt getragen werden. Die wichtigsten Änderungen der Empfehlungen, welche die Ventilation während der kardiopulmonalen Reanimation betreffen, sind nach Einschätzung der Autoren die Reduzierung des Beatmungszugvolumens von bis- her 800–1200 ml auf 500 ml bei der Maskenbeatmung (FiO2 > 0,4) eines Patienten mit ungesichertem Luftweg, die Verifizierung einer endotrachealen Intubation durch Kapnometrie und einen Ösophagus-Detektor und die Aufnahme von Larynxmaske und Kombitubus als alternative Beatmungshilfen bei nicht möglicher endotrachealer Intubation.

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  1. Medizinische Universität zu Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany

    Priv.-Doz. Dr. med. V. Dörges

  2. Klinik für Anaesthesie und Allgemeine Intensivmedizin, Leopold-Franzens-Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria

    Dr. med. V. Wenzel

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  1. Klinikum Benjamin Franklin, Medizinische Klinik II, Hindenburgdamm 30, 12200, Berlin, Germany

    H.-R. Arntz

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Dörges, V., Wenzel, V. (2002). Ventilation during cardiopulmonary resuscitation. In: Arntz, HR. (eds) Die Notfalltherapie bei akutem Kreislaufstillstand. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-642-57511-2_4

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