RESUMEN
The International Liaison Committee on Resuscitation has initiated a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation science. This is the third annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. It addresses the most recent published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. This summary addresses the role of cardiac arrest centers and dispatcher-assisted cardiopulmonary resuscitation, the role of extracorporeal cardiopulmonary resuscitation in adults and children, vasopressors in adults, advanced airway interventions in adults and children, targeted temperature management in children after cardiac arrest, initial oxygen concentration during resuscitation of newborns, and interventions for presyncope by first aid providers. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the certainty of the evidence on the basis of the Grading of Recommendations, Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence to Decision Framework Highlights sections. The task forces also listed priority knowledge gaps for further research.
Asunto(s)
Reanimación Cardiopulmonar/normas , Paro Cardíaco Extrahospitalario/terapia , Adolescente , Adulto , Anciano , Reanimación Cardiopulmonar/métodos , Niño , Preescolar , Epinefrina/uso terapéutico , Circulación Extracorporea/métodos , Circulación Extracorporea/normas , Humanos , Hipertermia Inducida/métodos , Hipertermia Inducida/normas , Lactante , Intubación Intratraqueal/métodos , Intubación Intratraqueal/normas , Persona de Mediana Edad , Respiración Artificial/métodos , Respiración Artificial/normas , Vasoconstrictores/uso terapéutico , Adulto JovenAsunto(s)
Reanimación Cardiopulmonar/normas , Servicios Médicos de Urgencia/normas , Paro Cardíaco/terapia , Manejo de la Vía Aérea/métodos , Manejo de la Vía Aérea/normas , Daño Encefálico Crónico/epidemiología , Daño Encefálico Crónico/etiología , Daño Encefálico Crónico/prevención & control , Reanimación Cardiopulmonar/educación , Reanimación Cardiopulmonar/métodos , Salas de Parto/normas , Parto Obstétrico/métodos , Urgencias Médicas , Servicios Médicos de Urgencia/métodos , Medicina Basada en la Evidencia , Femenino , Paro Cardíaco/tratamiento farmacológico , Masaje Cardíaco/efectos adversos , Masaje Cardíaco/métodos , Masaje Cardíaco/normas , Humanos , Incubadoras para Lactantes , Cuidado del Lactante/métodos , Cuidado del Lactante/normas , Recién Nacido , Recien Nacido Prematuro , Enfermedades del Prematuro/fisiopatología , Enfermedades del Prematuro/terapia , Monitoreo Fisiológico/métodos , Monitoreo Fisiológico/normas , Estudios Observacionales como Asunto , Embarazo , Complicaciones del Embarazo , Respiración Artificial/métodos , Respiración Artificial/normas , Tasa de SupervivenciaRESUMEN
Patent ductus arteriosus (PDA) continues to be one of the most common problems found in premature infants. The incidence is inversely related to gestation, but may be reduced by use of antenatal steroids, lower volume fluid regimen and judicious use of phototherapy. However, there continues to be controversy as to the appropriate indications for treatment, varying from prophylaxis on the basis of gestation to treatment only when a PDA is demonstrably significant. The situation is further complicated by differing diagnostic criteria for ductal patency or significance. Prophylactic treatment is likely to result in up to 64% of babies being treated unnecessarily. Early treatment of significant or symptomatic PDA depends upon accurate diagnosis. PDA closure can then be achieved using medical means, with surgery reserved for patients in whom this fails or in whom there are contra-indications. However, the optimum timing for intervention remains unknown.