Skip to main content
Top
Published in: Intensive Care Medicine 10/2019

01-10-2019 | Cardiopulmonary Resuscitation | Less is More in ICU

Vasopressors, antiarrhythmics, oxygen, and intubation in out-of-hospital cardiac arrest: possibly less is more

Authors: Claudio Sandroni, Markus B. Skrifvars, Jasmeet Soar

Published in: Intensive Care Medicine | Issue 10/2019

Login to get access

Excerpt

Out-of-hospital cardiac arrest (OHCA) is a major cause of death in Western countries [1]. While bystander cardiopulmonary resuscitation (CPR) and early defibrillation are associated with improved outcomes, the impact of advanced life support (ALS) is less clear [2]. Recently, a series of randomised controlled trials assessed the effect of major ALS interventions: tracheal intubation, vasopressor and antiarrhythmic drugs during CPR, and oxygenation, ventilation and hemodynamic management strategies after return of spontaneous circulation (ROSC). …
Literature
1.
go back to reference Stecker EC, Reinier K, Marijon E, Narayanan K, Teodorescu C, Uy-Evanado A, Gunson K, Jui J, Chugh SS (2014) Public health burden of sudden cardiac death in the United States. Circ Arrhythm Electrophysiol 7:212–217CrossRef Stecker EC, Reinier K, Marijon E, Narayanan K, Teodorescu C, Uy-Evanado A, Gunson K, Jui J, Chugh SS (2014) Public health burden of sudden cardiac death in the United States. Circ Arrhythm Electrophysiol 7:212–217CrossRef
2.
go back to reference Stiell IG, Wells GA, Field B, Spaite DW, Nesbitt LP, De Maio VJ, Nichol G, Cousineau D, Blackburn J, Munkley D, Luinstra-Toohey L, Campeau T, Dagnone E, Lyver M, Ontario Prehospital Advanced Life Support Study G (2004) Advanced cardiac life support in out-of-hospital cardiac arrest. N Engl J Med 351:647–656CrossRef Stiell IG, Wells GA, Field B, Spaite DW, Nesbitt LP, De Maio VJ, Nichol G, Cousineau D, Blackburn J, Munkley D, Luinstra-Toohey L, Campeau T, Dagnone E, Lyver M, Ontario Prehospital Advanced Life Support Study G (2004) Advanced cardiac life support in out-of-hospital cardiac arrest. N Engl J Med 351:647–656CrossRef
3.
go back to reference Paradis NA, Martin GB, Rivers EP, Goetting MG, Appleton TJ, Feingold M, Nowak RM (1990) Coronary perfusion pressure and the return of spontaneous circulation in human cardiopulmonary resuscitation. JAMA 263:1106–1113CrossRef Paradis NA, Martin GB, Rivers EP, Goetting MG, Appleton TJ, Feingold M, Nowak RM (1990) Coronary perfusion pressure and the return of spontaneous circulation in human cardiopulmonary resuscitation. JAMA 263:1106–1113CrossRef
4.
go back to reference Olasveengen TM, Sunde K, Brunborg C, Thowsen J, Steen PA, Wik L (2009) Intravenous drug administration during out-of-hospital cardiac arrest: a randomized trial. JAMA 302:2222–2229CrossRef Olasveengen TM, Sunde K, Brunborg C, Thowsen J, Steen PA, Wik L (2009) Intravenous drug administration during out-of-hospital cardiac arrest: a randomized trial. JAMA 302:2222–2229CrossRef
5.
go back to reference Hagihara A, Hasegawa M, Abe T, Nagata T, Wakata Y, Miyazaki S (2012) Prehospital epinephrine use and survival among patients with out-of-hospital cardiac arrest. JAMA 307:1161–1168CrossRef Hagihara A, Hasegawa M, Abe T, Nagata T, Wakata Y, Miyazaki S (2012) Prehospital epinephrine use and survival among patients with out-of-hospital cardiac arrest. JAMA 307:1161–1168CrossRef
6.
go back to reference Nakahara S, Tomio J, Takahashi H, Ichikawa M, Nishida M, Morimura N, Sakamoto T (2013) Evaluation of pre-hospital administration of adrenaline (epinephrine) by emergency medical services for patients with out of hospital cardiac arrest in Japan: controlled propensity matched retrospective cohort study. BMJ 347:f6829CrossRef Nakahara S, Tomio J, Takahashi H, Ichikawa M, Nishida M, Morimura N, Sakamoto T (2013) Evaluation of pre-hospital administration of adrenaline (epinephrine) by emergency medical services for patients with out of hospital cardiac arrest in Japan: controlled propensity matched retrospective cohort study. BMJ 347:f6829CrossRef
7.
go back to reference Perkins GD, Ji C, Deakin CD, Quinn T, Nolan JP, Scomparin C, Regan S, Long J, Slowther A, Pocock H, Black JJM, Moore F, Fothergill RT, Rees N, O’Shea L, Docherty M, Gunson I, Han K, Charlton K, Finn J, Petrou S, Stallard N, Gates S, Lall R, Collaborators P (2018) A randomized trial of epinephrine in out-of-hospital cardiac arrest. N Engl J Med 379:711–721CrossRef Perkins GD, Ji C, Deakin CD, Quinn T, Nolan JP, Scomparin C, Regan S, Long J, Slowther A, Pocock H, Black JJM, Moore F, Fothergill RT, Rees N, O’Shea L, Docherty M, Gunson I, Han K, Charlton K, Finn J, Petrou S, Stallard N, Gates S, Lall R, Collaborators P (2018) A randomized trial of epinephrine in out-of-hospital cardiac arrest. N Engl J Med 379:711–721CrossRef
8.
go back to reference Kudenchuk PJ, Brown SP, Daya M, Rea T, Nichol G, Morrison LJ, Leroux B, Vaillancourt C, Wittwer L, Callaway CW, Christenson J, Egan D, Ornato JP, Weisfeldt ML, Stiell IG, Idris AH, Aufderheide TP, Dunford JV, Colella MR, Vilke GM, Brienza AM, Desvigne-Nickens P, Gray PC, Gray R, Seals N, Straight R, Dorian P, Resuscitation Outcomes Consortium I (2016) Amiodarone, lidocaine, or placebo in out-of-hospital cardiac arrest. N Engl J Med 374:1711–1722CrossRef Kudenchuk PJ, Brown SP, Daya M, Rea T, Nichol G, Morrison LJ, Leroux B, Vaillancourt C, Wittwer L, Callaway CW, Christenson J, Egan D, Ornato JP, Weisfeldt ML, Stiell IG, Idris AH, Aufderheide TP, Dunford JV, Colella MR, Vilke GM, Brienza AM, Desvigne-Nickens P, Gray PC, Gray R, Seals N, Straight R, Dorian P, Resuscitation Outcomes Consortium I (2016) Amiodarone, lidocaine, or placebo in out-of-hospital cardiac arrest. N Engl J Med 374:1711–1722CrossRef
9.
go back to reference Benger JR, Kirby K, Black S, Brett SJ, Clout M, Lazaroo MJ, Nolan JP, Reeves BC, Robinson M, Scott LJ, Smartt H, South A, Stokes EA, Taylor J, Thomas M, Voss S, Wordsworth S, Rogers CA (2018) Effect of a strategy of a supraglottic airway device vs tracheal intubation during Out-of-hospital cardiac arrest on functional outcome: The AIRWAYS-2 randomized clinical trial. JAMA 320:779–791CrossRef Benger JR, Kirby K, Black S, Brett SJ, Clout M, Lazaroo MJ, Nolan JP, Reeves BC, Robinson M, Scott LJ, Smartt H, South A, Stokes EA, Taylor J, Thomas M, Voss S, Wordsworth S, Rogers CA (2018) Effect of a strategy of a supraglottic airway device vs tracheal intubation during Out-of-hospital cardiac arrest on functional outcome: The AIRWAYS-2 randomized clinical trial. JAMA 320:779–791CrossRef
10.
go back to reference Jabre P, Penaloza A, Pinero D, Duchateau FX, Borron SW, Javaudin F, Richard O, de Longueville D, Bouilleau G, Devaud ML, Heidet M, Lejeune C, Fauroux S, Greingor JL, Manara A, Hubert JC, Guihard B, Vermylen O, Lievens P, Auffret Y, Maisondieu C, Huet S, Claessens B, Lapostolle F, Javaud N, Reuter PG, Baker E, Vicaut E, Adnet F (2018) Effect of bag-mask ventilation vs endotracheal intubation during cardiopulmonary resuscitation on neurological outcome after out-of-hospital cardiorespiratory arrest: a randomized clinical trial. JAMA 319:779–787CrossRef Jabre P, Penaloza A, Pinero D, Duchateau FX, Borron SW, Javaudin F, Richard O, de Longueville D, Bouilleau G, Devaud ML, Heidet M, Lejeune C, Fauroux S, Greingor JL, Manara A, Hubert JC, Guihard B, Vermylen O, Lievens P, Auffret Y, Maisondieu C, Huet S, Claessens B, Lapostolle F, Javaud N, Reuter PG, Baker E, Vicaut E, Adnet F (2018) Effect of bag-mask ventilation vs endotracheal intubation during cardiopulmonary resuscitation on neurological outcome after out-of-hospital cardiorespiratory arrest: a randomized clinical trial. JAMA 319:779–787CrossRef
11.
go back to reference Wang HE, Schmicker RH, Daya MR, Stephens SW, Idris AH, Carlson JN, Colella MR, Herren H, Hansen M, Richmond NJ, Puyana JCJ, Aufderheide TP, Gray RE, Gray PC, Verkest M, Owens PC, Brienza AM, Sternig KJ, May SJ, Sopko GR, Weisfeldt ML, Nichol G (2018) Effect of a strategy of initial laryngeal tube insertion vs endotracheal intubation on 72-hour survival in adults with out-of-hospital cardiac arrest: a randomized clinical trial. JAMA 320:769–778CrossRef Wang HE, Schmicker RH, Daya MR, Stephens SW, Idris AH, Carlson JN, Colella MR, Herren H, Hansen M, Richmond NJ, Puyana JCJ, Aufderheide TP, Gray RE, Gray PC, Verkest M, Owens PC, Brienza AM, Sternig KJ, May SJ, Sopko GR, Weisfeldt ML, Nichol G (2018) Effect of a strategy of initial laryngeal tube insertion vs endotracheal intubation on 72-hour survival in adults with out-of-hospital cardiac arrest: a randomized clinical trial. JAMA 320:769–778CrossRef
12.
go back to reference Lemiale V, Dumas F, Mongardon N, Giovanetti O, Charpentier J, Chiche JD, Carli P, Mira JP, Nolan J, Cariou A (2013) Intensive care unit mortality after cardiac arrest: the relative contribution of shock and brain injury in a large cohort. Intensive Care Med 39:1972–1980CrossRef Lemiale V, Dumas F, Mongardon N, Giovanetti O, Charpentier J, Chiche JD, Carli P, Mira JP, Nolan J, Cariou A (2013) Intensive care unit mortality after cardiac arrest: the relative contribution of shock and brain injury in a large cohort. Intensive Care Med 39:1972–1980CrossRef
13.
go back to reference Sandroni C, Parnia S, Nolan JP (2019) Cerebral oximetry in cardiac arrest: a potential role but with limitations. Intensive Care Med 45:904–906CrossRef Sandroni C, Parnia S, Nolan JP (2019) Cerebral oximetry in cardiac arrest: a potential role but with limitations. Intensive Care Med 45:904–906CrossRef
14.
go back to reference Jakkula P, Pettila V, Skrifvars MB, Hastbacka J, Loisa P, Tiainen M, Wilkman E, Toppila J, Koskue T, Bendel S, Birkelund T, Laru-Sompa R, Valkonen M, Reinikainen M, Group Cs (2018) Targeting low-normal or high-normal mean arterial pressure after cardiac arrest and resuscitation: a randomised pilot trial. Intensive Care Med 44:2091–2101CrossRef Jakkula P, Pettila V, Skrifvars MB, Hastbacka J, Loisa P, Tiainen M, Wilkman E, Toppila J, Koskue T, Bendel S, Birkelund T, Laru-Sompa R, Valkonen M, Reinikainen M, Group Cs (2018) Targeting low-normal or high-normal mean arterial pressure after cardiac arrest and resuscitation: a randomised pilot trial. Intensive Care Med 44:2091–2101CrossRef
15.
go back to reference Jakkula P, Reinikainen M, Hastbacka J, Loisa P, Tiainen M, Pettila V, Toppila J, Lahde M, Backlund M, Okkonen M, Bendel S, Birkelund T, Pulkkinen A, Heinonen J, Tikka T, Skrifvars MB, Group Cs (2018) Targeting two different levels of both arterial carbon dioxide and arterial oxygen after cardiac arrest and resuscitation: a randomised pilot trial. Intensive Care Med 44:2112–2121CrossRef Jakkula P, Reinikainen M, Hastbacka J, Loisa P, Tiainen M, Pettila V, Toppila J, Lahde M, Backlund M, Okkonen M, Bendel S, Birkelund T, Pulkkinen A, Heinonen J, Tikka T, Skrifvars MB, Group Cs (2018) Targeting two different levels of both arterial carbon dioxide and arterial oxygen after cardiac arrest and resuscitation: a randomised pilot trial. Intensive Care Med 44:2112–2121CrossRef
16.
go back to reference Stammet P, Collignon O, Hassager C, Wise MP, Hovdenes J, Aneman A, Horn J, Devaux Y, Erlinge D, Kjaergaard J, Gasche Y, Wanscher M, Cronberg T, Friberg H, Wetterslev J, Pellis T, Kuiper M, Gilson G, Nielsen N, Investigators TT-T (2015) Neuron-specific enolase as a predictor of death or poor neurological outcome after out-of-hospital cardiac arrest and targeted temperature management at 33 degrees C and 36 degrees C. J Am Coll Cardiol 65:2104–2114CrossRef Stammet P, Collignon O, Hassager C, Wise MP, Hovdenes J, Aneman A, Horn J, Devaux Y, Erlinge D, Kjaergaard J, Gasche Y, Wanscher M, Cronberg T, Friberg H, Wetterslev J, Pellis T, Kuiper M, Gilson G, Nielsen N, Investigators TT-T (2015) Neuron-specific enolase as a predictor of death or poor neurological outcome after out-of-hospital cardiac arrest and targeted temperature management at 33 degrees C and 36 degrees C. J Am Coll Cardiol 65:2104–2114CrossRef
17.
go back to reference Ameloot K, De Deyne C, Eertmans W, Ferdinande B, Dupont M, Palmers PJ, Petit T, Nuyens P, Maeremans J, Vundelinckx J, Vanhaverbeke M, Belmans A, Peeters R, Demaerel P, Lemmens R, Dens J, Janssens S (2019) Early goal-directed haemodynamic optimization of cerebral oxygenation in comatose survivors after cardiac arrest: the Neuroprotect post-cardiac arrest trial. Eur Heart J 40:1804–1814CrossRef Ameloot K, De Deyne C, Eertmans W, Ferdinande B, Dupont M, Palmers PJ, Petit T, Nuyens P, Maeremans J, Vundelinckx J, Vanhaverbeke M, Belmans A, Peeters R, Demaerel P, Lemmens R, Dens J, Janssens S (2019) Early goal-directed haemodynamic optimization of cerebral oxygenation in comatose survivors after cardiac arrest: the Neuroprotect post-cardiac arrest trial. Eur Heart J 40:1804–1814CrossRef
Metadata
Title
Vasopressors, antiarrhythmics, oxygen, and intubation in out-of-hospital cardiac arrest: possibly less is more
Authors
Claudio Sandroni
Markus B. Skrifvars
Jasmeet Soar
Publication date
01-10-2019
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 10/2019
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-019-05727-6

Other articles of this Issue 10/2019

Intensive Care Medicine 10/2019 Go to the issue