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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Tuesday, December 15, 2015


Resultado de imagen de paramedics2 trial
"Over 50,000 people die each year following an out of hospital cardiac arrest (OHCA) in the UK(1, 2). Although initial resuscitation efforts restart the heart in about 25-30% of resuscitation attempts, most of these patients die in the next few days in hospital from severe brain damage(3) and overall survival (of attempted resuscitations) is less than 10%(1). Cardiac arrest causes a major burden on NHS resources (emergency treatment, post resuscitation care, rehabilitation) but treatment currently has a low chance of success. The drug adrenaline has been an integral component of advanced life support from the birth of modern cardiopulmonary resuscitation in the early 1960s. In guidelines written originally in 1961, Peter Safar recommended the use of very large doses of adrenaline: 10 mg intravenously or 0.5 mg intracardiac(4). Animal studies show that injection of adrenaline during cardiac arrest increases aortic tone and thereby augments coronary blood flow(5, 6). However there are limited reliable data to assess the effects of adrenaline on long-term outcomes after cardiac arrest. The International Liaison Committee for Resuscitation (ILCOR) synthesized the available evidence for adrenaline in 2010 (also re-assessed October 2012) and noted whilst it may improve the return of spontaneous circulation (ROSC) and short-term survival, there is insufficient evidence to suggest that adrenaline improves survival to discharge from hospital and neurological outcome. ILCOR stated that placebo-controlled trials to evaluate the use of any vasopressor in adult and paediatric cardiac arrest are needed(7)..."