Zerebrale Reanimation - Maßnahmen zum Schutz der Hirnfunktion während und nach der Reanimation

Summary

Neuronal injury following global cerebral ischaemia such as occurs in cardiac arrest, continues to be a central problem of patients in the post-reanimation phase. Current studies confirm the small number of patients who survive a cardiovascular collapse without suffering a neurological deficit. Particular attention must thus be paid to measures that serve to preserve neurological function. In the light of the extremely low tolerance of central neurones to ischaemia the aim here is to achieve rapid return of spontaneous circulation (ROSC). These measures include a rapid diagnostic work-up of an unconscious person and the early use of (automatic) defibrillators to treat ventricular fibrillation, and the choice of a suitable vasopressor. Promising current investigations suggest that the application of thrombolytic agents as causal treatment of a myocardial infarction or pulmonary embolism as the cause of a circulatory collapse, but also for improving cerebral perfusion is conceivable. The use of mild hypothermia (32-34°C) is already recommended by the International Liaison Committee on Resuscitation (ILCOR), and should thus be practised in all unconscious patients suffering a prehospital cardiac patient arrest.

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