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WITHDRAWN: Recommendations for Cardiopulmonary Resuscitation (CPR) of patients with suspected or confirmed COVID-19

Sérgio Timerman1,2,3, Hélio Penna Guimarães3,4,5,6, Roseny Dos Reis Rodrigues5,7

  • 1Faculdade de Medicina da Universidade de São Paulo (FMUSP), Hospital das Clínicas, Instituto do Coração (InCor), Centro de Treinamento de Emergências Cardiovasculares e Ressuscitação e do Time de Resposta Rápida, São Paulo, SP, Brazil.

Brazilian Journal of Anesthesiology (Elsevier)
|August 25, 2020
PubMed

Insights

Recommendations for cardiopulmonary resuscitation (CPR) during the COVID-19 pandemic emphasize full personal protective equipment (PPE) and early advanced airway management. Special considerations are needed for patients with hypoxia, arrhythmias, mechanical ventilation, and prone positioning.

Area of Science:

  • Emergency Medicine
  • Cardiology
  • Intensive Care Medicine
  • Anesthesiology

Background:

  • COVID-19 pandemic presents unique challenges for cardiopulmonary arrest (CPA) patient care.
  • Limited evidence necessitates clear guidance for healthcare teams.
  • Recommendations aim to protect both healthcare providers and patients.

Purpose of the Study:

  • To provide updated recommendations for cardiopulmonary resuscitation (CPR) in COVID-19 patients.
  • To guide healthcare teams in managing CPA during the pandemic.
  • To ensure optimal patient and provider safety.

Main Methods:

  • Development of guidelines by leading Brazilian medical associations (ABRAMEDE, SBC, AMIB, SBA).
  • Incorporation of existing international protocols (ILCOR 2015, AHA 2019) and Brazilian guidelines.
  • Focus on aerosol-generating procedures and specific patient conditions.

Main Results:

  • Mandatory use of full personal protective equipment (PPE) for aerosol-generating procedures during CPR.
  • Early advanced invasive airway insertion is crucial.
  • Use of High Efficiency Particulate Arrestance (HEPA) filters with bag-valve systems is required.
  • Specific protocols for CPR during mechanical ventilation and in prone positions are detailed.
  • Management of potential causes like hypoxia and COVID-19-related arrhythmias (QT interval changes, myocarditis) is essential.

Conclusions:

  • Adherence to these recommendations is vital for effective and safe CPR in COVID-19 patients.
  • These guidelines aim to standardize care and minimize risks in a high-uncertainty environment.
  • Continuous updates based on emerging evidence are encouraged.

Keywords:
Advanced cardiac life supportArrest, cardiopulmonaryCardiopulmonary resuscitationHeart arrest

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