Notfallmedizin up2date 2013; 8(4): 317-337
DOI: 10.1055/s-0033-1346913
Forschungsergebnisse für die Praxis
Georg Thieme Verlag KG Stuttgart · New York

Aktuelle Ergebnisse notfallmedizinischer Forschung 2012/2013

Jochen Hinkelbein
,
Stefan Braunecker
,
Dominique Singer
,
Holger Thiele
,
Bernd W. Böttiger
Further Information

Publication History

Publication Date:
16 December 2013 (online)

Kernaussagen
  • Für die Kompressionsfrequenz bei der kardiopulmonalen Reanimation könnte das Optimum bei etwa 125/min liegen.

  • Die außerklinische Implantation einer ECMO kann evtl. zu einer Verkürzung der Zeitdauer bis zum Erreichen eines Kreislaufs nach einer Reanimation führen, wenngleich die Implantation zeitaufwendig ist.

  • Die Durchführung eines Ganzkörper-CT im Rahmen der Polytraumaversorgung senkt die Mortalität.

  • Das Basendefizit ist ein einfach zu erhebender Laborparameter, der eine Abschätzung des Transfusionsbedarfs und der Mortalität bei Traumapatienten ermöglicht.

  • Wenn nicht innerhalb einer Stunde ein Katheterlabor zur Verfügung steht, ist auch eine frühzeitige prähospitale Fibrinolyse mit einer zeitnahen PCI nicht mit einer Verbesserung der Prognose assoziiert. Allerdings ist die Rate an Komplikationen nach Fibrinolyse höher.

 
  • Literatur

  • 1 Nolan JP, Hazinski MF, Billi JE et al. Part 1: Executive summary: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Resuscitation 2010; 81S: e1-e25
  • 2 Nolan JP, Soar J, Zideman DA et al. European Resuscitation Council guidelines for resuscitation 2010 section 1. Executive summary. Resuscitation 2010; 81: 1219-1276
  • 3 Idris AH, Guffey D, Aufderheide TP et al. Relationship between chest compression rates and outcomes from cardiac arrest. Circulation 2012; 125: 3004-3012
  • 4 Kilgannon JH, Jones AE, Parrillo JE et al. Relationship between supranormal oxygen tension and outcome after resuscitation from cardiac arrest. Circulation 2011; 123: 2717-2722
  • 5 Kilgannon JH, Jones AE, Shapiro NI et al. Association between arterial hyperoxia following resuscitation from cardiac arrest and in-hospital mortality. J Am Med Assoc 2010; 303: 2165-2171
  • 6 Pilcher J, Weatherhall M, Shirtcliffe P et al. The effect of hyperoxia following cardiac arrest – A systematic review and meta-analysis of animal trials. Resuscitation 2012; 83: 417-422
  • 7 Bellomo R, Bailey M, Eastwood GM et al. Arterial hyperoxia and in-hospital mortality after resuscitation from cardiac arrest. Crit Care 2011; 15: R90
  • 8 Spindelboek W, Schindler O, Moser A et al. Increasing arterial oxygen partial pressure during cardiopulmonary resuscitation is associated with improved rates of hospital admission. Resuscitation 2013; 84: 770-775
  • 9 Wetsch WA, Spelten O, Hellmich M et al. Comparison of different video laryngoscopes for emergency intubation in a standardized airway manikin with immobilized cervical spine by experienced anaesthetists. A randomized, controlled crossover trial. Resuscitation 2012; 83: 740-745
  • 10 Wetsch WA, Carlitscheck M, Spelten O et al. Success rates and endotracheal tube insertion times of experienced emergency physicians using five video laryngoscopes: a randomised trial in a simulated trapped car accident victim. Eur J Anaesthesiol 2011; 28: 849-858
  • 11 Cavus E, Callies A, Doerges V et al. The C-MAC videolaryngoscope for prehospital emergency intubation: a prospective, multicentre, observational study. Emerg Med J 2011; 28: 650-653
  • 12 Park SO, Baek KJ, Hong DY et al. Feasibility of the video-laryngoscope (Glidescope®) for endotracheal intubation during uninterrupted chest compressions in actual advanced life support: A clinical observational study in an urban emergency department. Resuscitation 2013; 84: 1233-1237
  • 13 Hinkelbein J, Hellmich M. Conclusions need to be based on sound data: keep an eye on both bias and imprecision. Eur J Anaesthesiol 2013; 30: 93-94
  • 14 Bernhard M, Mohr S, Weigand MA et al. Developing the skill of endotracheal intubation: implication for emergency medicine. Acta Anaesthesiol Scand 2012; 56: 164-171
  • 15 Lamhaut L, Jouffroy R, Soldan M et al. Safety and feasibility of prehospital extra corporeal life support implementation by non-surgeons for out-of-hospital refractory cardiac arrest. Resuscitation 2013; 84: 1233-1237
  • 16 Deakin CD, Morrison LJ, Morley PT et al. Part 8: Advanced life support: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Resuscitation 2010; 81 Suppl 1: e93-e174
  • 17 Deakin CD, Nolan JP, Soar J et al. European Resuscitation Council Guidelines for Resuscitation 2010 Section 4. Adult advanced life support. Resuscitation 2010; 81: 1305-1352
  • 18 Pittl U, Schratter A, Desch S et al. Invasive versus non-invasive cooling after in- and out-of-hospital cardiac arrest: a randomized trial. Clin Res Cardiol 2013; 102: 607-614
  • 19 Cronberg T, Brizzi M, Liedholm LJ et al. Neurological prognostication after cardiac arrest–recommendations from the Swedish Resuscitation Council. Resuscitation 2013; 84: 867-872
  • 20 Ruchholtz S, Lefering R, Paffrath T et al. Rückgang der Traumaletalität. Dtsch Ärztebl 2008; 105: 225-231
  • 21 Bansal V, Fortlage D, Lee J et al. Hemorrhage is more prevalent than brain injury in early trauma deaths: The golden six hours. Eur J Trauma Emerg Surg 2009; 35: 26-30
  • 22 Bernhard M, Becker TK, Nowe T et al. Introduction of a treatment algorithm can improve the early management of emergency patients in the resuscitation room. Resuscitation 2007; 73: 362-373
  • 23 Huber-Wagner S, Biberthaler P, Häberle S et al. Whole-Body CT in haemodynamically unstable severely injured patients–a retrospective, multicentre study. PLoS One 2013; 8: e68880
  • 24 Huber-Wagner S, Lefering R, Qvick LM et al. Effect of whole-body CT during trauma resuscitation on survival: a retrospective, multicentre study. Lancet 2009; 373: 1455-1461
  • 25 Mutschler M, Nienaber U, Brockamp T et al. Renaissance of base deficit for the initial assessment of trauma patients: a base deficit-based classification for hypovolemic shock developed on data from 16,305 patients derived from the TraumaRegister DGU®. Crit Care 2013; 17: R42
  • 26 Mutschler M, Nienaber U, Münzberg M et al. The shock index revisited – a fast guide to transfusion requirement? A retrospective analysis on 21, 853 patients derived from the TraumaRegister DGU. Crit Care 2013; 17: R172
  • 27 Bell MJ, Kochanek PM. Pediatric traumatic brain injury in 2012: the year with new guidelines and common data elements. Crit Care Clin 2013; 29: 223-238
  • 28 Sigurtà A, Zanaboni C, Canavesi K et al. Intensive care for pediatric traumatic brain injury. Intensive Care Med 2013; 39: 129-136
  • 29 Choe MC, Babikian T, DiFiori J et al. A pediatric perspective on concussion pathophysiology. Curr Opin Pediatr 2012; 24: 689-695
  • 30 Mayer AR, Ling JM, Yang Z et al. Diffusion abnormalities in pediatric mild traumatic brain injury. J Neurosci 2012; 32: 17961-17969
  • 31 Blume H, Hawash K. Subacute concussion-related symptoms and postconcussion syndrome in pediatrics. Curr Opin Pediatr 2012; 24: 724-730
  • 32 Fein JA, Zempsky WT, Cravero JP. Committee on Pediatric Emergency Medicine and Section on Anesthesiology and Pain Medicine, American Academy of Pediatrics. Relief of pain and anxiety in pediatric patients in emergency medical systems. Pediatrics 2012; 130: e1391-e1405
  • 33 Knudson JD, Neish SR, Cabrera AG et al. Prevalence and outcomes of pediatric in-hospital cardiopulmonary resuscitation in the United States: an analysis of the Kids Inpatient Database. Crit Care Med 2012; 40: 2940-2944
  • 34 Lowry AW, Knudson JD, Cabrera AG et al. Cardiopulmonary resuscitation in hospitalized children with cardiovascular disease: estimated prevalence and outcomes from the kids inpatient database. Pediatr Crit Care Med 2013; 14: 248-255
  • 35 Zwingmann J, Mehlhorn AT, Hammer T et al. Survival and neurologic outcome after traumatic out-of-hospital cardiopulmonary arrest in a pediatric and adult population: a systematic review. Crit Care 2012; 16: R117
  • 36 Hussmann B, Lefering R, Kauther MD et al. Influence of prehospital volume replacement on outcome in polytraumatized children. Crit Care 2012; 16: R201
  • 37 Valois-Gómez T, Oofuvong M, Auer G et al. Incidence of difficult bag-mask ventilation in children: a prospective observational study. Pediatr Anesth 2013; 23: 920-926
  • 38 Badaki-Makun O, Nadel F, Donoghue A et al. Chest compression quality over time in pediatric resuscitations. Pediatrics 2013; 131: e797-e804
  • 39 Mittiga MR, Geis GL, Kerrey BT et al. The spectrum and frequency of critical procedures performed in a pediatric emergency department: Implications of a provider-level view. Ann Emerg Med 2013; 61: 263-270
  • 40 Haubner LY, Barry JS, Johnston LC et al. Neonatal intubation performance: Room for improvement in tertiary neonatal intensive care units. Resuscitation 2013; DOI: 10.1016/j.resuscitation.2013.03.0142013.
  • 41 Cheng A, Hunt EA, Donoghue A et al. Examining pediatric resuscitation education using simulation and scripted debriefing: A multicenter randomized trial. JAMA Pediatr 2013; DOI: 10.1001/jamapediatrics.2013.13892013.
  • 42 Clark JD, Dudzinski DM. The culture of dysthanasia: attempting CPR in terminally ill children. Pediatrics 2013; 131: 572-580
  • 43 Klingensmith GJ, Tamborlane WV, Wood J et al. Pediatric Diabetes Consortium. Diabetic ketoacidosis at diabetes onset: still an all too common threat in youth. J Pediatr 2013; 162: 330-334.e1
  • 44 Bassham B, Estrada C, Abramo T. Hyperglycemic hyperosmolar syndrome in the pediatric patient: a case report and review of the literature. Pediatr Emerg Care 2012; 28: 699-702
  • 45 White PC, Dickson BA. Low morbidity and mortality in children with diabetic ketoacidosis treated with isotonic fluids. J Pediatr 2013; DOI: 10.1016/j.jpeds.2013.02.0052013.
  • 46 Glaser NS, Wootton-Gorges SL, Buonocore MH et al. Subclinical cerebral edema in children with diabetic ketoacidosis randomized to 2 different rehydration protocols. Pediatrics 2013; 131: e73-e80
  • 47 OʼBrien NF, Mella C. Brain tissue oxygenation-guided management of diabetic ketoacidosis induced cerebral edema. Pediatr Crit Care Med 2012; 13: e383-e388
  • 48 Glaser NS, Ghetti S, Casper TC et al. Pediatric diabetic ketoacidosis, fluid therapy, and cerebral injury: the design of a factorial randomized controlled trial. Pediatr Diabetes 2013; DOI: 10.1111/pedi.120272013.
  • 49 Leventhal JM, Gaither JR. Incidence of serious injuries due to physical abuse in the United States. Pediatrics 2012; 130: e847-e852
  • 50 Jones L, Bellis MA, Wood S et al. Prevalence and risk of violence against children with disabilities: a systematic review and meta-analysis of observational studies. Lancet 2012; 380: 899-907
  • 51 Sheets LK, Leach ME, Koszewski IJ et al. Sentinel injuries in infants evaluated for child physical abuse. Pediatrics 2013; 131: 701-707
  • 52 Lindberg DM, Shapiro RA, Laskey AL et al. Prevalence of abusive injuries in siblings and household contacts of physically abused children. Pediatrics 2012; 130: 193-201
  • 53 Harper NS, Eddleman S, Lindberg DM. The utility of follow-up skeletal surveys in child abuse. Pediatrics 2013; 131: e672-e678
  • 54 Singh R, Squires J, Fromkin JB et al. Assessing the use of follow-up skeletal surveys in children with suspected physical abuse. J Trauma Acute Care Surg 2012; 73: 972-976
  • 55 Huang H, Gundapuneedi T, Rao U. White matter disruptions in adolescents exposed to childhood maltreatment and vulnerability to psychopathology. Neuropsychopharmacology 2012; 37: 2693-2701
  • 56 Piteau SJ, Ward MG, Barrowman NJ et al. Clinical and radiographic characteristics associated with abusive and nonabusive head trauma: a systematic review. Pediatrics 2012; 130: 315-323
  • 57 Hymel KP, Willson DF, Boos SC et al. Pediatric Brain Injury Research Network (PediBIRN) Investigators. Derivation of a clinical prediction rule for pediatric abusive head trauma. Pediatr Crit Care Med 2013; 14: 210-220
  • 58 Minns RA, Jones PA, Tandon A et al. Prediction of inflicted brain injury in infants and children using retinal imaging. Pediatrics 2012; 130: e1227-e1234
  • 59 Lindberg DM, Shapiro RA, Blood EA et al. ExSTRA investigators. Utility of hepatic transaminases in children with concern for abuse. Pediatrics 2013; 131: 268-275
  • 60 Carpenter SL, Abshire TC, Anderst JD. Section on Hematology/Oncology and Committee on Child Abuse and Neglect of the American Academy of Pediatrics. Evaluating for suspected child abuse: conditions that predispose to bleeding. Pediatrics 2013; 131: e1357-e1373
  • 61 Anderst JD, Carpenter SL, Abshire TC. Section on Hematology/Oncology and Committee on Child Abuse and Neglect of the American Academy of Pediatrics. Evaluation for bleeding disorders in suspected child abuse. Pediatrics 2013; 131: e1314-e1322
  • 62 Carlo WA, Finer NN, Walsh MC et al. Target ranges of oxygen saturation in extremely preterm infants. N Engl J Med 2010; 362: 1959-1969
  • 63 Vaucher YE, Peralta-Carcelen M, Finer NN et al. SUPPORT Study Group of the Eunice Kennedy Shriver NICHD Neonatal Research Network. Neurodevelopmental outcomes in the early CPAP and pulse oximetry trial. N Engl J Med 2012; 367: 2495-2504
  • 64 Polin RA, Bateman D. Oxygen-saturation targets in preterm infants. N Engl J Med 2013; 368: 2141-2142
  • 65 The BOOST II United Kingdom, Australia, and New Zealand Collaborative Groups. Oxygen saturation and outcomes in preterm infants. N Engl J Med 2013; DOI: 10.1056/NEJMoa1302298.
  • 66 Stenson B, Brocklehurst P, Tarnow-Mordi W. U.K. BOOST II trial, Australian BOOST II trial, New Zealand BOOST II trial. Increased 36-week survival with high oxygen saturation target in extremely preterm infants. N Engl J Med 2011; 364: 1680-1682
  • 67 Carlo WA, Bell EF, Walsh MC. SUPPORT Study Group of the Eunice Kennedy Shriver NICHD Neonatal Research Network. Oxygen saturation targets in extremely preterm infants. N Engl J Med 2013; 368: 1949-1950
  • 68 Drazen JM, Solomon CG, Greene MF. Informed Consent and SUPPORT. N Engl J Med 2013; 368: 1929-1931
  • 69 Magnus D, Caplan AL. Risk, consent, and SUPPORT. N Engl J Med 2013; 368: 1864-1865
  • 70 Schmidt B, Whyte RK, Asztalos EV et al. Effects of targeting higher vs lower arterial oxygen saturations on death or disability in extremely preterm infants: a randomized clinical Trial. JAMA 2013; 309: 2111-2120
  • 71 Bancalari E, Claure N. Oxygenation targets and outcomes in premature infants. JAMA 2013; 309: 2161-2162
  • 72 DelCastillo J, López-Herce J, Matamoros M et al. Hyperoxia, hypocapnia and hypercapnia as outcome factors after cardiac arrest in children. Resuscitation 2012; 83: 1456-1461
  • 73 Desai NR, Bhatt DL. The state of periprocedural antiplatelet therapy after recent trials. JACC Cardiovasc Interv 2010; 3: 571-583
  • 74 Heestermans AA, van Werkum JW, Taubert D et al. Impaired bioavailability of clopidogrel in patients with a ST-segment elevation myocardial infarction. Thromb Res 2008; 122: 776-781
  • 75 Bhatt DL, Topol EJ. Current role of platelet glycoprotein II b/III a inhibitors in acute coronary syndromes. JAMA 2000; 284: 1549-1558
  • 76 Bhatt DL, Stone GW, Mahaffey KW et al. Effect of platelet inhibition with cangrelor during PCI on ischemic events. N Engl J Med 2013; 368: 1303-1313
  • 77 Angiolillo DJ, Schneider DJ, Bhatt DL et al. Pharmacodynamic effects of cangrelor and clopidogrel: the platelet function substudy from the cangrelor versus standard therapy to achieve optimal management of platelet inhibition (CHAMPION) trials. J Thromb Thrombolysis 2012; 34: 44-55
  • 78 Armstrong PW, Boden WE. Reperfusion paradox in ST-segment elevation myocardial infarction. Ann Intern Med 2011; 155: 389-391
  • 79 Terkelsen CJ, Sorensen JT, Maeng M et al. System delay and mortality among patients with STEMI treated with primary percutaneous coronary intervention. JAMA 2010; 304: 763-771
  • 80 Armstrong PW, Gershlick AH, Goldstein P et al. Fibrinolysis or primary PCI in ST-segment elevation myocardial infarction. N Engl J Med 2013; 368: 1379-1387