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Reanimación cardiopulmonar en circunstancias especiales
Jasmeet Soar1, Lance B Becker2, Katherine M Berg3
1Anaesthesia and Intensive Care Medicine, Southmead Hospital, North Bristol NHS Trust, Bristol, UK.
Lancet (London, England)
|August 29, 2021
Resumen
La reanimación cardiopulmonar (RCP) es crucial para la supervivencia del paro cardíaco. La RCP y la desfibrilación tempranas mejoran los resultados, pero las circunstancias especiales requieren intervenciones personalizadas para obtener los mejores resultados.
Área de la Ciencia:
- Medicina de emergencia
- Cardiología
- Cuidados intensivos
Sus antecedentes:
- La reanimación cardiopulmonar (RCP) se dirige principalmente a los paros cardíacos con origen cardíaco primario.
- El paro cardíaco puede deberse a diversas circunstancias especiales, incluida la asfixia, el trauma y el COVID-19.
- Estas causas no cardíacas representan un porcentaje creciente de paros cardíacos tratados.
Objetivo del estudio:
- Revisar las pruebas actuales para la RCP en circunstancias especiales.
- Resaltar la necesidad de intervenciones adaptadas a los escenarios de paro cardíaco no primario.
- Para enfatizar la naturaleza sensible al tiempo de todos los tratamientos de paro cardíaco.
Principales métodos:
- Revisión de la literatura de estudios sobre la RCP en circunstancias especiales.
- Análisis de la certeza de las pruebas para intervenciones específicas.
- Síntesis de las directrices y recomendaciones actuales.
Principales resultados:
- La RCP estándar con compresiones torácicas tempranas y desfibrilación es vital para los paros cardíacos primarios.
- Las circunstancias especiales (por ejemplo, trauma, embolia pulmonar, hipotermia, anafilaxia, COVID-19, embarazo, perioperatorio) requieren intervenciones adicionales y específicas.
- La evidencia que apoya las intervenciones para estas circunstancias especiales es a menudo de baja o muy baja certeza.
- Se necesita más investigación para fortalecer la base de evidencia de estas condiciones.
Conclusiones:
- Si bien la RCP estándar es crítica, abordar las causas reversibles en circunstancias especiales es esencial para mejorar la supervivencia.
- La eficacia de la RCP se maximiza cuando se inicia con prontitud, independientemente de la causa subyacente.
- Hay una necesidad significativa de más investigación de alta calidad en RCP para escenarios de paro cardíaco no primarios.
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