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Article ; Online: Improving survival after cardiac arrest in Europe

Lina Horriar / Nadine Rott / Bernd W. Böttiger

Resuscitation Plus, Vol 17, Iss , Pp 100533- (2024)

The synergetic effect of rescue chain strategies

1481

Abstract: Sudden cardiac arrest is a global problem and is considered the third leading cause of death in industrialized countries. Patient survival rates after out-of-hospital cardiac arrest (OHCA) vary significantly between countries and continents. In ... ...

Abstract	Sudden cardiac arrest is a global problem and is considered the third leading cause of death in industrialized countries. Patient survival rates after out-of-hospital cardiac arrest (OHCA) vary significantly between countries and continents. In particular, the 2021 European Resuscitation Council (ERC) Resuscitation Guidelines place a special focus on the chain of survival of patients after OHCA. As a complex, interconnected approach, the focus is on: Raising awareness for cardiac arrest and lay resuscitation, school children’s education in resuscitation “KIDS SAVE LIVES”, first responder systems – technologies to engage the community, telephone-assisted resuscitation (telephone-CPR; T-CPR) by dispatchers, and cardiac arrest centers (CAC) for further treatment in specialized hospitals. The Systems Saving Lives approach is a comprehensive strategy that emphasizes the interconnectedness of all links in the chain of survival following an OHCA, with a particular focus on the relationship between the community and emergency medical services (EMS). This system-level approach emphasizes the importance of the connection between all those involved in the chain of survival. It has a high potential to improve overall survival after OHCA. Therefore, it is recommended that these strategies be promoted and expanded in all countries.
Keywords	Out-of-hospital cardiac arrest ; Systems Saving Lives ; KIDS SAVE LIVES ; Lay resuscitation ; Chain of survival ; Specialties of internal medicine ; RC581-951
Subject code	360
Language	English
Publishing date	2024-03-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A narrative review of European public awareness initiatives for cardiac arrest

Lina Horriar / Nadine Rott / Federico Semeraro / Bernd W. Böttiger

Resuscitation Plus, Vol 14, Iss , Pp 100390- (2023)

2023

Abstract: A high resuscitation rate can lead to better overall survival after cardiac arrest. In Europe, various campaigns in the field of lay resuscitation are achieving up to a threefold increase in survival. As part of the new Systems Saving Lives (SSL) chapter, ...

Abstract	A high resuscitation rate can lead to better overall survival after cardiac arrest. In Europe, various campaigns in the field of lay resuscitation are achieving up to a threefold increase in survival. As part of the new Systems Saving Lives (SSL) chapter, the European Resuscitation Council (ERC) guidelines recommend cardiac awareness campaigns to engage the broader community. It has been noted that countries with high survival rates after an out-of-hospital cardiac arrest (OHCA) start education in resuscitation techniques at school age. The ERC 2021 guidelines recommend that all schoolchildren should routinely receive CPR training each year. Since 2015, the KIDS SAVE LIVES statement recommended for two hours of instruction per year in all schools worldwide by age of 12. Cardiac awareness campaigns like World Restart a Heart Day (WRAH) are aimed to raise awareness about resuscitation and to train as many people as possible.
Keywords	Lay resuscitation ; KIDS SAVE LIVES ; Bystander CPR ; Cardiac awareness campaigns ; World Restart a Heart ; Cardiac arrest ; Specialties of internal medicine ; RC581-951
Subject code	370
Language	English
Publishing date	2023-06-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Implementation of systems saving lives in Greece

Anastasios Stefanakis / Theodoros Kalyvas / Nadine Rott / Bernd W. Böttiger / Evangelia Sigala

Resuscitation Plus, Vol 13, Iss , Pp 100358- (2023)

2023

Keywords	Specialties of internal medicine ; RC581-951
Language	English
Publishing date	2023-03-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: CPR-related cognitive activity, consciousness, awareness and recall, and its management

Rebecca L. West / Quentin Otto / Ian R. Drennan / Sarah Rudd / Bernd W. Böttiger / Sam Parnia / Jasmeet Soar

Resuscitation Plus, Vol 10, Iss , Pp 100241- (2022)

A scoping review

2022

Abstract: Background: There are increasing numbers of reports of cognitive activity, consciousness, awareness and recall related to cardiopulmonary resuscitation (CPR) and interventions such as the use of sedative and analgesic drugs during CPR. Objectives: This ... ...

Abstract	Background: There are increasing numbers of reports of cognitive activity, consciousness, awareness and recall related to cardiopulmonary resuscitation (CPR) and interventions such as the use of sedative and analgesic drugs during CPR. Objectives: This scoping review aims to describe the available evidence concerning CPR-related cognitive activity, consciousness, awareness and recall and interventions such as the use of sedative and analgesic drugs during CPR. Methods: A literature search was conducted of Medline, Embase and CINAHL from inception to 21 October 2021. We included case studies, observational studies, review studies and grey literature. Results: We identified 8 observational studies including 40,317 patients and 464 rescuers, and 26 case reports including 33 patients. The reported prevalence of CPR-induced consciousness was between 0.23% to 0.9% of resuscitation attempts, with 48–59% of experienced professional rescuers surveyed estimated to have observed CPR-induced consciousness. CPR-induced consciousness is associated with professional rescuer CPR, witnessed arrest, a shockable rhythm, increased return of spontaneous circulation (ROSC), and survival to hospital discharge when compared to patients without CPR-induced consciousness. Few studies of sedation for CPR-induced consciousness were identified. Although local protocols for treating CPR-induced consciousness exist, there is no widely accepted guidance. Conclusions: CPR-related cognitive activity, consciousness, awareness and recall is uncommon but increasingly reported by professional rescuers. The data available was heterogeneous in nature and not suitable for progression to a systematic review process. Although local treatment protocols exist for management of CPR-induced consciousness, there are no widely accepted treatment guidelines. More studies are required to investigate the management of CPR-induced consciousness.
Keywords	Cardiac arrest ; Cardiopulmonary resuscitation ; Consciousness ; Awareness ; Post-traumatic stress disorder ; Near death experience ; Specialties of internal medicine ; RC581-951
Subject code	120
Language	English
Publishing date	2022-06-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Addressing the Helper’s and Victim’s Gender Is Crucial in Schoolchildren Resuscitation Training—A Prospective, Educative Interventional Trial

Sabine Wingen / Hannes Ecker / Daniel C. Schroeder / Bérénice Bartholme / Bernd W. Böttiger / Wolfgang A. Wetsch

Journal of Clinical Medicine, Vol 11, Iss 2384, p

2022 Volume 2384

Abstract: Background: A victim’s gender is a known factor that influences the willingness of adult bystanders to perform cardiopulmonary resuscitation (CPR) if an out-of-hospital cardiac arrest (OHCA) occurs. This study aims to identify whether gender ... ...

Abstract	Background: A victim’s gender is a known factor that influences the willingness of adult bystanders to perform cardiopulmonary resuscitation (CPR) if an out-of-hospital cardiac arrest (OHCA) occurs. This study aims to identify whether gender characteristics of OHCA victims are also relevant to schoolchildren, who are the key target group of CPR trainings worldwide. Methods: A prospective, educative intervention study was performed in schoolchildren (5th–7th grade). Schoolchildren’s willingness to perform CPR was assessed by means of questionnaires before (t0) and after (t1) standardized CPR training. Participants were asked how determined they were to perform CPR in male and female OHCA victims on a 5-point Likert scale (not being determined to being very determined). A data analysis was performed according to the gender characteristics of schoolchildren. Results: Overall, 342 schoolchildren aged 10–15 years were included, and 166 male (MG) and 176 female (FG) schoolchildren served as a comparison group. Before (t0) and after (t1) the intervention, females showed a significantly higher general willingness to perform CPR than males (t0: 97.1% vs. 89.0%; p < 0.003 and t1: 95.7% vs. 98.9%; p = 0.038). The general willingness to perform CPR after training had a stronger increase in males (8.0% vs. 2.3%; p = 0.017). In the case that the OHCA victim was female, male schoolchildren were less willing to perform CPR than females at baseline (MG: n = 101;60.8% vs. FG: n = 147;84.5%; p < 0.001) and after training (MG: n = 97;58.4% vs. FG: n = 138;79.3%; p < 0.001). At t1, CPR willingness for female victims was improved in males (MG: n = 36;21.7% vs. FG: n = 19;10.9%; p = 0.006). Conclusions: The gender characteristics of OHCA victims, as well as schoolchildren themselves, have a relevant impact on the willingness to perform CPR. Training concepts should effectively motivate male schoolchildren to reduce preexisting inhibitions, especially towards female OHCA patients. Trial registration: This study was registered ...
Keywords	cardiopulmonary resuscitation ; out-of-hospital cardiac arrest ; education and training ; bystander ; schoolchildren ; KIDS SAVE LIVES ; Medicine ; R
Subject code	370
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Recommendations on the structure, personal, and organization of intensive care units

Christian Waydhas / Reimer Riessen / Andreas Markewitz / Florian Hoffmann / Lorenz Frey / Bernd W. Böttiger / Sebastian Brenner / Thorsten Brenner / Teresa Deffner / Matthias M. Deininger / Uwe Janssens / Stefan Kluge / Gernot Marx / Stefan Schwab / Andreas W. Unterberg / Felix Walcher / Thomas van den Hooven

Frontiers in Medicine, Vol

2023 Volume 10

Abstract: BackgroundIntensive care units (ICU) are central facilities of medical care in hospitals world-wide and pose a significant financial burden on the health care system.ObjectivesTo provide guidance and recommendations for the requirements of (infra) ... ...

Abstract	BackgroundIntensive care units (ICU) are central facilities of medical care in hospitals world-wide and pose a significant financial burden on the health care system.ObjectivesTo provide guidance and recommendations for the requirements of (infra)structure, personal, and organization of intensive care units.Design and settingDevelopment of recommendations based on a systematic literature search and a formal consensus process from a group of multidisciplinary and multiprofessional specialists from the German Interdisciplinary Association of Intensive Care and Emergency Medicine (DIVI). The grading of the recommendation follows the report from an American College of Chest Physicians Task Force.ResultsThe recommendations cover the fields of a 3-staged level of intensive care units, a 3-staged level of care with respect to severity of illness, qualitative and quantitative requirements of physicians and nurses as well as staffing with physiotherapists, pharmacists, psychologists, palliative medicine and other specialists, all adapted to the 3 levels of ICUs. Furthermore, proposals concerning the equipment and the construction of ICUs are supplied.ConclusionThis document provides a detailed framework for organizing and planning the operation and construction/renovation of ICUs.
Keywords	intensive care medicine ; personal ; organization ; structural requirements ; quality of care ; recommendation ; Medicine (General) ; R5-920
Subject code	650
Language	English
Publishing date	2023-06-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Outcomes of audio-instructed and video-instructed dispatcher-assisted cardiopulmonary resuscitation

Karol Bielski / Bernd W. Böttiger / Michal Pruc / Aleksandra Gasecka / Mariusz Sieminski / Milosz J. Jaguszewski / Jacek Smereka / Natasza Gilis-Malinowska / Frank W. Peacock / Lukasz Szarpak

Annals of Medicine, Vol 54, Iss 1, Pp 464-

a systematic review and meta-analysis

2022 Volume 471

Abstract: Background The present meta-analysis of clinical and simulation trials aimed to compare video-instructed dispatcher-assisted bystander cardiopulmonary resuscitation (V-DACPR) with conventional audio-instructed dispatcher-assisted bystander ... ...

Abstract	Background The present meta-analysis of clinical and simulation trials aimed to compare video-instructed dispatcher-assisted bystander cardiopulmonary resuscitation (V-DACPR) with conventional audio-instructed dispatcher-assisted bystander cardiopulmonary resuscitation (C-DACPR). Methods We searched PubMed, Embase, Web of Science, Cochrane Collaboration databases and Scopus from inception until June 10, 2021. The primary outcomes were the prehospital return of spontaneous circulation (ROSC), survival to hospital discharge, and survival to hospital discharge with a good neurological outcome for clinical trials, and chest compression quality for simulation trials. Odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) indicated the pooled effect. The analyses were performed with the RevMan 5.4 and STATA 14 software. Results Overall, 2 clinical and 8 simulation trials were included in this meta-analysis. In clinical trials, C-DACPR and V-DACPR were characterised by, respectively, 11.8% vs. 24.3% of prehospital ROSC (OR = 0.46; 95% CI: 0.30, 0.69; I2 = 66%; p < .001), 10.7% vs. 22.3% of survival to hospital discharge (OR = 0.46; 95% CI: 0.30, 0.70; I2 = 69%; p < .001), and 6.3% vs. 16.0% of survival to hospital discharge with a good neurological outcome (OR = 0.39; 95% CI: 0.23, 0.67; I2 = 73%; p < .001). In simulation trials, chest compression rate per minute equalled 91.3 ± 22.6 for C-DACPR and 107.8 ± 12.6 for V-DACPR (MD = −13.40; 95% CI: −21.86, −4.95; I2 = 97%; p = .002). The respective values for chest compression depth were 38.7 ± 14.3 and 41.8 ± 12.5 mm (MD = −2.67; 95% CI: −8.35, 3.01; I2 = 98%; p = .36). Conclusions As compared with C-DACPR, V-DACPR significantly increased prehospital ROSC and survival to hospital discharge. Under simulated resuscitation conditions, V-DACPR exhibited a higher rate of adequate chest compressions than C-DACPR.Key messages Bystander cardiopulmonary resuscitation parameters significantly depend on the dispatcher’s support and the manner of ...
Keywords	emergency medical dispatcher ; video-call ; cardiac arrest ; cardiopulmonary resuscitation ; systematic review ; meta-analysis ; Medicine ; R
Subject code	610
Language	English
Publishing date	2022-12-01T00:00:00Z
Publisher	Taylor & Francis Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Zero-Heat-Flux Thermometry for Non-Invasive Measurement of Core Body Temperature in Pigs.

Maria Guschlbauer / Alexandra C Maul / Xiaowei Yan / Holger Herff / Thorsten Annecke / Anja Sterner-Kock / Bernd W Böttiger / Daniel C Schroeder

PLoS ONE, Vol 11, Iss 3, p e

2016 Volume 0150759

Abstract: Hypothermia is a severe, unpleasant side effect during general anesthesia. Thus, temperature surveillance is a prerequisite in general anesthesia settings during experimental surgeries. The gold standard to measure the core body temperature (Tcore) is ... ...

Abstract	Hypothermia is a severe, unpleasant side effect during general anesthesia. Thus, temperature surveillance is a prerequisite in general anesthesia settings during experimental surgeries. The gold standard to measure the core body temperature (Tcore) is placement of a Swan-Ganz catheter in the pulmonary artery, which is a highly invasive procedure. Therefore, Tcore is commonly examined in the urine bladder and rectum. However, these procedures are known for their inaccuracy and delayed record of temperatures. Zero-heat-flux (ZHF) thermometry is an alternative, non-invasive method quantifying Tcore in human patients by applying a thermosensoric patch to the lateral forehead. Since the porcine cranial anatomy is different to the human's, the optimal location of the patch remains unclear to date. The aim was to compare three different patch locations of ZHF thermometry in a porcine hypothermia model. Hypothermia (33.0 °C Tcore) was conducted in 11 anesthetized female pigs (26-30 kg). Tcore was measured continuously by an invasive Swan-Ganz catheter in the pulmonary artery (Tpulm). A ZHF thermometry device was mounted on three different defined locations. The smallest average difference between Tpulm and TZHF during stable temperatures was 0.21 ± 0.16 °C at location A, where the patch was placed directly behind the eye. Also during rapidly changing temperatures location A showed the smallest bias with 0.48 ± 0.29 °C. Location A provided the most reliable data for Tcore. Therefore, the ZHF thermometry patch should be placed directly behind the left temporal corner of the eye to provide a non-invasive method for accurate measurement of Tcore in pigs.
Keywords	Medicine ; R ; Science ; Q
Subject code	630
Language	English
Publishing date	2016-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Automated External Defibrillator

Enrico Baldi / Niccolò B. Grieco / Giuseppe Ristagno / Hajriz Alihodžić / Valentine Canon / Alexei Birkun / Ruggero Cresta / Diana Cimpoesu / Carlo Clarens / Julian Ganter / Andrej Markota / Pierre Mols / Olympia Nikolaidou / Martin Quinn / Violetta Raffay / Fernando Rosell Ortiz / Ari Salo / Remy Stieglis / Anneli Strömsöe /

Ingvild Tjelmeland / Stefan Trenkler / Jan Wnent / Jan-Thorsten Grasner / Bernd W. Böttiger / Simone Savastano

Journal of Clinical Medicine, Vol 10, Iss 5018, p

Heterogeneity of Legislation, Mapping and Use across Europe. New Insights from the ENSURE Study

2021 Volume 5018

Abstract: Introduction: The rapid use of an automated external defibrillator (AED) is crucial for increased survival after an out-of-hospital cardiac arrest (OHCA). Many factors could play a role in limiting the chance of an AED use. We aimed to verify the ... ...

Abstract	Introduction: The rapid use of an automated external defibrillator (AED) is crucial for increased survival after an out-of-hospital cardiac arrest (OHCA). Many factors could play a role in limiting the chance of an AED use. We aimed to verify the situation regarding AED legislation, the AED mapping system and first responders (FRs) equipped with an AED across European countries. Methods: We performed a survey across Europe entitled “European Study about AED Use by Lay Rescuers” (ENSURE), asking the national coordinators of the European Registry of Cardiac Arrest (EuReCa) program to complete it. Results: Nineteen European countries replied to the survey request for a population covering 128,297,955 inhabitants. The results revealed that every citizen can use an AED in 15 countries whereas a training certificate was required in three countries. In one country, only EMS personnel were allowed to use an AED. An AED mapping system and FRs equipped with an AED were available in only 11 countries. The AED use rate was 12–59% where AED mapping and FR systems were implemented, which was considerably higher than in other countries (0–7.9%), reflecting the difference in OHCA survival. Conclusions: Our survey highlighted a heterogeneity in AED legislation, AED mapping systems and AED use in Europe, which was reflected in different AED use and survival.
Keywords	out-of-hospital cardiac arrest (OHCA) ; automated external defibrillator (AED) system ; legislation ; first responders ; Medicine ; R
Subject code	320
Language	English
Publishing date	2021-10-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Oesophageal heat exchangers with a diameter of 11mm or 14.7mm are equally effective and safe for targeted temperature management.

Daniel C Schroeder / Maria Guschlbauer / Alexandra C Maul / Daniel A Cremer / Ingrid Becker / David de la Puente Bethencourt / Peter Paal / Stephan A Padosch / Wolfgang A Wetsch / Thorsten Annecke / Bernd W Böttiger / Anja Sterner-Kock / Holger Herff

PLoS ONE, Vol 12, Iss 3, p e

2017 Volume 0173229

Abstract: BACKGROUND:Targeted temperature management (TTM) is widely used in critical care settings for conditions including hepatic encephalopathy, hypoxic ischemic encephalopathy, meningitis, myocardial infarction, paediatric cardiac arrest, spinal cord injury, ... ...

Abstract	BACKGROUND:Targeted temperature management (TTM) is widely used in critical care settings for conditions including hepatic encephalopathy, hypoxic ischemic encephalopathy, meningitis, myocardial infarction, paediatric cardiac arrest, spinal cord injury, traumatic brain injury, ischemic stroke and sepsis. Furthermore, TTM is a key treatment for patients after out-of-hospital cardiac-arrest (OHCA). However, the optimal cooling method, which is quick, safe and cost-effective still remains controversial. Since the oesophagus is adjacent to heart and aorta, fast heat-convection to the central blood-stream could be achieved with a minimally invasive oesophageal heat exchanger (OHE). To date, the optimal diameter of an OHE is still unknown. While larger diameters may cause thermal- or pressure-related tissue damage after long-term exposure to the oesophageal wall, smaller diameter (e.g., gastric tubes, up to 11mm) may not provide effective cooling rates. Thus, the objective of the study was to compare OHE-diameters of 11mm (OHE11) and 14.7mm (OHE14.7) and their effects on tissue and cooling capability. METHODS:Pigs were randomized to OHE11 (N = 8) or OHE14.7 (N = 8). After cooling, pigs were maintained at 33°C for 1 hour. After 10h rewarming, oesophagi were analyzed by means of histopathology. The oesophagus of four animals from a separate study that underwent exactly the identical preparation and cooling protocol described above but received a maintenance period of 24h were used as histopathological controls. RESULTS:Mean cooling rates were 2.8±0.4°C°C/h (OHE11) and 3.0±0.3°C °C/h (OHE14.7; p = 0.20). Occasional mild acute inflammatory transepithelial infiltrates were found in the cranial segment of the oesophagus in all groups including controls. Deviations from target temperature were 0.1±0.4°C (OHE11) and 0±0.1°C (OHE14.7; p = 0.91). Rewarming rates were 0.19±0.07°C °C/h (OHE11) and 0.20±0.05°C °C/h (OHE14.7; p = 0.75). CONCLUSIONS:OHE with diameters of 11 mm and 14.7 mm achieve effective cooling rates for TTM and ...
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2017-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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