New Insights Into Effective CPR: Cardiocerebral Resuscitation for Primary Cardiac Arrest Treatment Update
Cardiocerebral resuscitation is a new approach to patients with primary cardiac arrestthat has been shown to dramatically increase survival. The term cardiocerebral is[Rev Cardiovasc Med. 2009;10(3):125-133 doi: 10.3909/ricm0462]used to stress that the issue is immediate and effective support of the central circulation.Cardiocerebral resuscitation consists of continuous chest compressions—withoutmouth-to-mouth ventilations—administered by bystanders, and a new algorithm foremergency medical services that consists of sets of 200 chest compressions before andimmediately after electrocardiographic analysis and, if indicated, a single shock.Ventilation is initially provided by passive oxygen insufflation rather than withintubation or bag-mask ventilation. Early establishment of intravenous or intraosseousaccess for epinephrine is emphasized. Postresuscitation care for comatose patientsincludes early coronary intervention and 24 hours of mild hypothermia. Studies showmarked improvement in prehospital cardiac arrest patients with return of spontaneouscirculation who subsequently received specialized postresuscitation care.