Interpretation of the Updates in the Use of Antiarrhythmic Drugs during Resuscitation of Patients with VF/pVT Cardiac Arrest or Immediately after ROSC in 2018 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations

doi:10.12114/j.issn.1007-9572.2019.00.296

Abstract

Abstract: In 2018，the American Heart Association （AHA） and the International Liaison Committee on Resuscitation （ILCOR） updated the guidelines on cardiopulmonary resuscitation and emergency cardiovascular care，mainly focused on the use of antiarrhythmic drugs during and immediately after shock-refractory ventricular fibrillation （VF） and pulseless ventricular tachycardia （pVT） cardiac arrest.The updates address the role of use of antiarrhythmic drugs or placebos or using no drugs during cardiopulmonary resuscitation or the period immediately （within one hour） after return of spontaneous circulation （ROSC） in the prognosis of the patient.AHA and ILCOR systematically reviewed and summarized the most recent published evidence，updated the procedure and management of advanced life support task force，and published the documents on the AHA official website and in Circulation.This review aimed to interpret the updates.

Key words: Cardiopulmonary resuscitation；Heart arrest；Anti-arrhythmia agents；Ventricular fibrillation；Tachycardia, ventricular；Guidebooks；American Heart Association；International Liaison Committee on Resuscitation

摘要： 2018年，美国心脏病协会（AHA）和国际复苏联络委员会（ILCOR）均对心肺复苏及心血管急救指南进行了年度更新，主要是针对心搏骤停期间或之后使用抗心律失常药物治疗电除颤难复律性心室颤动（VF）或无脉性室性心动过速（pVT）方面的变更。本次指南的更新是基于回答心肺复苏期间或自主循环恢复（ROSC）后早期（在第1个小时内）施用任何其他抗心律失常药物或安慰剂或不施用药物的情况是否会影响预后这个问题。AHA和ILCOR对已发表的文献进行了系统的回顾和总结，对高级生命支持（ACLS）的流程与管理进行了更新，并在AHA官网及Circulation杂志刊登了相关文件。本文旨在对关于心搏骤停期间或之后使用抗心律失常药物更新作出解读。

关键词: 心肺复苏术；心脏停搏；抗心律失常药；心室颤动；心动过速, 室性；指南；美国心脏病协会；国际复苏联络委员会

SHANG Na,ZHOU Rongbin. Interpretation of the Updates in the Use of Antiarrhythmic Drugs during Resuscitation of Patients with VF/pVT Cardiac Arrest or Immediately after ROSC in 2018 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations　[J]. Chinese General Practice, 2019, 22(20): 2393-2397. DOI: 10.12114/j.issn.1007-9572.2019.00.296.
商娜,周荣斌. 2018年心肺复苏和心血管急救科学与治疗建议的国际共识——关于心搏骤停期间或之后使用抗心律失常药物的更新解读[J]. 中国全科医学, 2019, 22(20): 2393-2397. DOI: 10.12114/j.issn.1007-9572.2019.00.296.

References

［1］DEBARD M L.The history of cardiopulmonary resuscitation［J］．Ann Emerg Med，1980，9（5）：273-275.
［2］SASSON C，ROGERS M A，DAHL J，et al．Predictors of survival from out-of-hospital cardiac arrest：a systematic review and meta-analysis［J］．Circ Cardiovasc Qual Outcomes，2010，3（1）：63-81．DOI：10.1161/CIRCOUTCOMES.109.889576.
［3］ONG M E，SHIN S D，DE SOUZA N N，et al．Outcomes for out-of-hospital cardiac arrests across 7 countries in Asia：the Pan Asian Resuscitation Outcomes Study （PAROS）［J］．Resuscitation，2015，96（7）：100-108．DOI：10.1016/j.resuscitation.2015.07.026.
［4］BECK B，BRAY J，CAMERON P，et al．Regional variation in the characteristics，incidence and outcomes of out-of-hospital cardiac arrest in Australia and New Zealand：results from the Aus-ROC Epistry［J］．Resuscitation，2018，126：49-57．DOI：10.1016/j.resuscitation.2018.02.029.
［5］GR?SNER J T，BEIN B.Reanimation - erweiterte ma?nahmen für erwachsene （adult advanced life support）［J］．An?sthesiol Intensivmed Notfallmed Schmerzther，2016，51（3）：188-195．DOI：10.1055/s-0041-103638.
［6］BENJAMIN E J，BLAHA M J，CHIUVE S E，et al．Heart disease and stroke statistics—2017 update：a report from the American Heart Association［J］．Circulation，2017，135（10）：e146-603．DOI：10.1161/CIR.0000000000000485.
［7］RADESCHI G，MINA A，BERTA G，et al．Incidence and outcome of in-hospital cardiac arrest in Italy：a multicentre observational study in the Piedmont Region［J］．Resuscitation，2017，119：48-55．DOI：10.1016/j.resuscitation.2017.06.020.
［8］NOLAN J P，SOAR J，SMITH G B，et al．Incidence and outcome of in-hospital cardiac arrest in the United Kingdom National Cardiac Arrest Audit［J］．Resuscitation，2014，85（8）：987-992．DOI：10.1016/j.resuscitation.2014.04.002.
［9］PERMAN S M，STANTON E，SOAR J，et al．Location of in-hospital cardiac arrest in the United States-variability in event rate and outcomes［J］．J Am Heart Assoc，2016，5（10）：e003638．DOI：10.1161/JAHA.116.003638.
［10］CALLAWAY C W，SOAR J，AIBIKI M，et al．Part 4：advanced life support：2015 International Consensus on Cardiopulmonary Resuscitation and emergency cardiovascular care science with treatment recommendations［J］．Circulation，2015，132（16 Suppl 1）：S84-145．DOI：10.1161/CIR.0000000000000273.
［11］SOAR J，CALLAWAY C W，AIBIKI M，et al．Part 4：advanced life support：2015 International Consensus on Cardiopulmonary Resuscitation and emergency cardiovascular care science with treatment recommendations［J］．Resuscitation，2015，95：e71-120．DOI：10.1016/j.resuscitation.2015.07.042.
［12］KUDENCHUK P J，COBB L A，COPASS M K，et al．Amiodarone for resuscitation after out-of-hospital cardiac arrest due to ventricular fibrillation［J］．N Engl J Med，1999，341（12）：871-878．DOI：10.1056/NEJM199909163411203.
［13］KUDENCHUK P J，BROWN S P，DAYA M，et al．Amiodarone，lidocaine，or placebo in out-of-hospital cardiac arrest［J］．N Engl J Med，2016，374（18）：1711-1722．DOI：10.1056/NEJMoa1514204.
［14］PANCHAL A R，BERG K M，KUDENCHUK P J，et al．2018 American Heart Association focused update on advanced cardiovascular life support use of antiarrhythmic drugs during and immediately after cardiac arrest：an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care［J］．Circulation，2018，138（23）：e740-749．DOI：10.1161/CIR.0000000000000613.
［15］SOAR J，DONNINO M W，MACONOCHIE I，et al．2018 International Consensus on Cardiopulmonary Resuscitation and emergency cardiovascular care science with treatment recommendations summary［J］．Circulation，2018，138（23）：e714-730．DOI：10.1161/CIR.0000000000000611.
［16］BHANJI F，DONOGHUE A J，WOLFF M S，et al．Part 14：education：2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care［J］．Circulation，2015，132（18 Suppl 2）：S561-573．DOI：10.1161/CIR.0000000000000268.
［17］NEUMAR R W，SHUSTER M，CALLAWAY C W，et al．Part 1：executive summary：2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care［J］．Circulation，2015，132（18 Suppl 2）：S315-367．DOI：10.1161/CIR.0000000000000252.
［18］DORIAN P，CASS D，SCHWARTZ B，et al．Amiodarone as compared with lidocaine for shock-resistant ventricular fibrillation［J］．N Engl J Med，2002，346（12）：884-890．DOI：10.1056/NEJMoa013029.