Standardisierte Reanimation auf der Intensivstation – Was ist zu beachten?

Der inner- und außerklinische Herzkreislaufstillstand stellt aufgrund hoher Inzidenzen und hoher Mortalitätsraten ein herausragendes Gesundheitsproblem dar. Amerikanische und europäische Fachgesellschaften geben in zeitlichen Intervallen in Leitlinien standardisierte Behandlungspfade vor. Dagegen zeigen Surveillance-Programme, dass eine große Varianz in der Erfolgsrate einer Reanimation besteht. Im Kontext der Standardprozeduren für die kardiopulmonale Reanimation auf unserer interdisziplinären Intensivstation möchten wir hier die essentiellen Punkte für eine erfolgreiche Reanimation beleuchten. Dabei handelt es sich im Wesentlichen um eine adäquate Kardiokompression, eine ausreichende Ventilation und ein kontinuierliches Monitoring der Reanimation bzw. deren Evaluierung nach Abschluss der Maßnahmen. Darüber hinaus soll auf die weiteren Schritte zur Therapie einer initial frustranen Reanimation unter Anwendung der Herzlungenmaschine und die erweiterten diagnostischen Schritte hingewiesen werden.

In and out-of-hospital cardiac arrest provide a major health problem due to high incidence and mortality rates. The responsible American and European societies issue guidelines with standardized treatment algorithms in a regular interval. Official surveillance programs, however, suggest a high variance in resuscitation success. In the context of our standard operating procedure for cardiac arrest on our interdisciplinary intensive care unit, we here intend to outline key aspects of a successful resuscitation procedure. This refers to the mode of cardio-compressions, an adequate ventilation and a continuous monitoring during all steps taken. We furthermore wish to address techniques, e.g. extracorporal life support devices which are applied in case of resuscitation failure. Finally, post-resuscitation diagnostic steps are highlighted.

Key words

Resuscitation - ECLS - ROSC - cardiac arrest

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