[Patient care of patients with myocardial infarction in Hungary. Analysis of National Myocardial Infarction Registry data collecting in 2015]. / A szívinfarktus miatt kezelt betegek ellátása Magyarországon. A Nemzeti Szívinfarktus Regiszter 2015. évi adatainak elemzése.

The authors summarize the most relevant data of myocardial infarction patients according to the National Myocardial Infarction Registry data base. In 2015 12,681 patients had 12,941 acute myocardial infarctions. Less than half of patients (44.4%) were treated with ST elevation myocardial infarction. National Ambulance Service was the first medical contact of more than half (51.4%) of patients with ST elevation infarction. Prehospital thrombolysis was occasionally done (0.23%), but 91.6% of the patients were treated in hospital with invasive facilities. The median of the ischaemic time (time between onset of symptoms and arrival at the invasive laboratory) was 223 minutes. Most of the patients (94%) with positive coronary arteriography were treated with percutaneous coronary intervention. The 30 day mortality of the whole group was 12.8% vs. 8.6% of patients treated with an invasive procedure. CONCLUSION: comparing the national and international registry data we conclude that we should analyse and decrease the prehospital delay time to improve the patient care in Hungary. Orv. Hetil., 2017, 158(3), 90-93.

[The novelties of adult advanced life support and post-resuscitation therapy]. / A felnott emelt szintu újraélesztés és a postresuscitatiós ellátás újdonságai.

The fourth element of chain-of-survival contains advanced life support and post-resuscitation treatment. Both treatment options influence the outcome of patients suffering cardiac arrest. Advanced life support includes all interventions that require special medical equipment and expertise. High-quality chest compressions and early defibrillation (if indicated) compose the main elements of advanced life support. Clarifying and treating the cause of cardiac arrest have also high priority, in which point-of-care ultrasound plays an important role. In addition, securing higher level of airway and capnography, securing intravenous or intraosseous line, and the parenteral administration of drugs - such as epinephrine or amiodarone - are the most important steps of advanced life support. If conventional therapy is unsuccessful, extracorporeal circulatory support can be used in special patient populations. The protection of vital organs that are sensitive to hypoxia (brain and heart) has a high priority after the return of spontaneous circulation beside the causative treatment of cardiac arrest. The most important parts of the supportive post-resuscitation treatment are: targeting normoxia, normocapnia, normotension, normoglycemia, and the application of target temperature management. Orv Hetil. 2023; 164(12): 454-462.

EuReCa ONE-27 Nations, ONE Europe, ONE Registry: A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe.

INTRODUCTION: The aim of the EuReCa ONE study was to determine the incidence, process, and outcome for out of hospital cardiac arrest (OHCA) throughout Europe. METHODS: This was an international, prospective, multi-centre one-month study. Patients who suffered an OHCA during October 2014 who were attended and/or treated by an Emergency Medical Service (EMS) were eligible for inclusion in the study. Data were extracted from national, regional or local registries. RESULTS: Data on 10,682 confirmed OHCAs from 248 regions in 27 countries, covering an estimated population of 174 million. In 7146 (66%) cases, CPR was started by a bystander or by the EMS. The incidence of CPR attempts ranged from 19.0 to 104.0 per 100,000 population per year. 1735 had ROSC on arrival at hospital (25.2%), Overall, 662/6414 (10.3%) in all cases with CPR attempted survived for at least 30 days or to hospital discharge. CONCLUSION: The results of EuReCa ONE highlight that OHCA is still a major public health problem accounting for a substantial number of deaths in Europe. EuReCa ONE very clearly demonstrates marked differences in the processes for data collection and reported outcomes following OHCA all over Europe. Using these data and analyses, different countries, regions, systems, and concepts can benchmark themselves and may learn from each other to further improve survival following one of our major health care events.