Future directions for resuscitation research V: ultra-advanced life support
Identifieur interne : 001D67 ( Main/Exploration ); précédent : 001D66; suivant : 001D68Future directions for resuscitation research V: ultra-advanced life support
Auteurs : S. A. Tisherman [États-Unis] ; K. Vandevelde [Belgique] ; P. Safar [États-Unis] ; T. Morioka [Japon] ; W. Obrist [États-Unis] ; L. Corne [Belgique] ; R. F. Buckman [États-Unis] ; S. Rubertsson [États-Unis] ; H. E. Stephenson [États-Unis] ; A. Grenvik [États-Unis] ; R. J. White [États-Unis]Source :
- Resuscitation [ 0300-9572 ] ; 1997.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Recherche scientifique, Homme.
English descriptors
- KwdEn :
Abstract
Copyright (c) 1997 Elsevier Science Ireland Ltd. All rights reserved. Standard external cardiopulmonary resuscitation (SECPR) frequently produces very low perfusion pressures, which are inadequate to achieve restoration of spontaneous circulation (ROSC) and intact survival, particularly when the heart is diseased. Ultra-advanced life support (UALS) techniques may allow support of vital organ systems until either the heart recovers or cardiac repair or replacement is performed. Closed-chest emergency cardiopulmonary bypass (CPB) provides control of blood flow, pressure, composition and temperature, but has so far been applied relatively late. This additional low-flow time may preclude conscious survival. An easy, quick method for vessel access and a small preprimed system that could be taken into the field are needed. Open-chest CPR (OCCPR) is physiologically superior to SECPR, but has also been initiated too late in prior studies. Its application in the field has recently proven feasible. Variations of OCCPR, which deserve clinical trials inside and outside hospitals, include 'minimally invasive direct cardiac massage' (MIDCM), using a pocket-size plunger-like device inserted via a small incision and 'direct mechanical ventricular actuation' (DMVA), using a machine that pneumatically drives a cup placed around the heart. Other novel UALS approaches for further research include the use of an aortic balloon catheter to improve coronary and cerebral blood flow during SECPR, aortic flush techniques and a double-balloon aortic catheter that could allow separate perfusion (and cooling) of the heart, brain and viscera for optimal resuscitation of each. Decision-making, initiation of UALS methods and diagnostic evaluations must be rapid to maximize the potential for ROSC and facilitate decision-making regarding long-term circulatory support versus withdrawal of life support for hopeless cases. Research and development of UALS technique needs to be coordinated with cerebral resuscitation research. Copyright © 1997 Elsevier Science Ireland Ltd.
Affiliations:
- Belgique, Japon, États-Unis
- Missouri (État), Ohio, Pennsylvanie, Région de Bruxelles-Capitale
- Bruxelles, Pittsburgh
- Université de Pittsburgh
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Corne</name><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>University Hospital, Free University of Brussels</s1><s2>Brussels</s2><s3>BEL</s3><sZ>6 aut.</sZ></inist:fA14><country>Belgique</country><placeName><settlement type="city">Bruxelles</settlement><region nuts="2">Région de Bruxelles-Capitale</region></placeName></affiliation></author><author><name sortKey="Buckman, R F" sort="Buckman, R F" uniqKey="Buckman R" first="R. F." last="Buckman">R. F. Buckman</name><affiliation wicri:level="2"><inist:fA14 i1="06"><s1>Temple University School of Medicine</s1><s2>Philadelphia, PA</s2><s3>USA</s3><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Rubertsson, S" sort="Rubertsson, S" uniqKey="Rubertsson S" first="S." last="Rubertsson">S. 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Grenvik</name><affiliation wicri:level="4"><inist:fA14 i1="03"><s1>Departments of Anesthesiology and Neurosurgery, University of Pittsburgh</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>5 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Pennsylvanie</region><settlement type="city">Pittsburgh</settlement></placeName><orgName type="university">Université de Pittsburgh</orgName></affiliation></author><author><name sortKey="White, R J" sort="White, R J" uniqKey="White R" first="R. J." last="White">R. J. White</name><affiliation wicri:level="2"><inist:fA14 i1="08"><s1>Metro Health Medical Center</s1><s2>Cleveland, OH</s2><s3>USA</s3><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Ohio</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">97-0447781</idno><date when="1997">1997</date><idno type="stanalyst">PASCAL 97-0447781 Elsevier</idno><idno type="RBID">Pascal:97-0447781</idno><idno type="wicri:Area/PascalFrancis/Corpus">000177</idno><idno type="wicri:Area/PascalFrancis/Curation">000157</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000156</idno><idno type="wicri:doubleKey">0300-9572:1997:Tisherman S:future:directions:for</idno><idno type="wicri:Area/Main/Merge">001D81</idno><idno type="wicri:Area/Main/Curation">001D67</idno><idno type="wicri:Area/Main/Exploration">001D67</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Future directions for resuscitation research V: ultra-advanced life support</title><author><name sortKey="Tisherman, S A" sort="Tisherman, S A" uniqKey="Tisherman S" first="S. A." last="Tisherman">S. A. Tisherman</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Safar Center for Resuscitation Research, University of Pittsburgh, 3434 Fifth Avenue</s1><s2>Pittsburgh, PA 15260</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Pennsylvanie</region><settlement type="city">Pittsburgh</settlement></placeName><orgName type="university">Université de Pittsburgh</orgName></affiliation></author><author><name sortKey="Vandevelde, K" sort="Vandevelde, K" uniqKey="Vandevelde K" first="K." last="Vandevelde">K. Vandevelde</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>St. Jans Hospital</s1><s2>Brugge</s2><s3>BEL</s3><sZ>2 aut.</sZ></inist:fA14><country>Belgique</country><wicri:noRegion>St. Jans Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Safar, P" sort="Safar, P" uniqKey="Safar P" first="P." last="Safar">P. Safar</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Safar Center for Resuscitation Research, University of Pittsburgh, 3434 Fifth Avenue</s1><s2>Pittsburgh, PA 15260</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Pennsylvanie</region><settlement type="city">Pittsburgh</settlement></placeName><orgName type="university">Université de Pittsburgh</orgName></affiliation></author><author><name sortKey="Morioka, T" sort="Morioka, T" uniqKey="Morioka T" first="T." last="Morioka">T. Morioka</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Kumamoto University School of Medicine</s1><s2>Kumamoto</s2><s3>JPN</s3><sZ>4 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>Kumamoto University School of Medicine</wicri:noRegion></affiliation></author><author><name sortKey="Obrist, W" sort="Obrist, W" uniqKey="Obrist W" first="W." last="Obrist">W. Obrist</name><affiliation wicri:level="4"><inist:fA14 i1="03"><s1>Departments of Anesthesiology and Neurosurgery, University of Pittsburgh</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>5 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Pennsylvanie</region><settlement type="city">Pittsburgh</settlement></placeName><orgName type="university">Université de Pittsburgh</orgName></affiliation></author><author><name sortKey="Corne, L" sort="Corne, L" uniqKey="Corne L" first="L." last="Corne">L. Corne</name><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>University Hospital, Free University of Brussels</s1><s2>Brussels</s2><s3>BEL</s3><sZ>6 aut.</sZ></inist:fA14><country>Belgique</country><placeName><settlement type="city">Bruxelles</settlement><region nuts="2">Région de Bruxelles-Capitale</region></placeName></affiliation></author><author><name sortKey="Buckman, R F" sort="Buckman, R F" uniqKey="Buckman R" first="R. F." last="Buckman">R. F. Buckman</name><affiliation wicri:level="2"><inist:fA14 i1="06"><s1>Temple University School of Medicine</s1><s2>Philadelphia, PA</s2><s3>USA</s3><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Rubertsson, S" sort="Rubertsson, S" uniqKey="Rubertsson S" first="S." last="Rubertsson">S. Rubertsson</name><affiliation wicri:level="4"><inist:fA14 i1="03"><s1>Departments of Anesthesiology and Neurosurgery, University of Pittsburgh</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>5 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Pennsylvanie</region><settlement type="city">Pittsburgh</settlement></placeName><orgName type="university">Université de Pittsburgh</orgName></affiliation></author><author><name sortKey="Stephenson, H E" sort="Stephenson, H E" uniqKey="Stephenson H" first="H. E." last="Stephenson">H. E. Stephenson</name><affiliation wicri:level="2"><inist:fA14 i1="07"><s1>No affiliation given</s1><s2>Columbia, MO</s2><s3>USA</s3><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Missouri (État)</region></placeName></affiliation></author><author><name sortKey="Grenvik, A" sort="Grenvik, A" uniqKey="Grenvik A" first="A." last="Grenvik">A. Grenvik</name><affiliation wicri:level="4"><inist:fA14 i1="03"><s1>Departments of Anesthesiology and Neurosurgery, University of Pittsburgh</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>5 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Pennsylvanie</region><settlement type="city">Pittsburgh</settlement></placeName><orgName type="university">Université de Pittsburgh</orgName></affiliation></author><author><name sortKey="White, R J" sort="White, R J" uniqKey="White R" first="R. J." last="White">R. J. White</name><affiliation wicri:level="2"><inist:fA14 i1="08"><s1>Metro Health Medical Center</s1><s2>Cleveland, OH</s2><s3>USA</s3><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Ohio</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Resuscitation</title><title level="j" type="abbreviated">Resuscitation</title><idno type="ISSN">0300-9572</idno><imprint><date when="1997">1997</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Resuscitation</title><title level="j" type="abbreviated">Resuscitation</title><idno type="ISSN">0300-9572</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Cardiocirculatory arrest</term><term>Human</term><term>Intensive cardiocirculatory care</term><term>Optimization</term><term>Scientific research</term><term>Technique</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Arrêt cardiocirculatoire</term><term>Réanimation cardiocirculatoire</term><term>Recherche scientifique</term><term>Traitement</term><term>Technique</term><term>Optimisation</term><term>Homme</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Recherche scientifique</term><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Copyright (c) 1997 Elsevier Science Ireland Ltd. All rights reserved. Standard external cardiopulmonary resuscitation (SECPR) frequently produces very low perfusion pressures, which are inadequate to achieve restoration of spontaneous circulation (ROSC) and intact survival, particularly when the heart is diseased. Ultra-advanced life support (UALS) techniques may allow support of vital organ systems until either the heart recovers or cardiac repair or replacement is performed. Closed-chest emergency cardiopulmonary bypass (CPB) provides control of blood flow, pressure, composition and temperature, but has so far been applied relatively late. This additional low-flow time may preclude conscious survival. An easy, quick method for vessel access and a small preprimed system that could be taken into the field are needed. Open-chest CPR (OCCPR) is physiologically superior to SECPR, but has also been initiated too late in prior studies. Its application in the field has recently proven feasible. Variations of OCCPR, which deserve clinical trials inside and outside hospitals, include 'minimally invasive direct cardiac massage' (MIDCM), using a pocket-size plunger-like device inserted via a small incision and 'direct mechanical ventricular actuation' (DMVA), using a machine that pneumatically drives a cup placed around the heart. Other novel UALS approaches for further research include the use of an aortic balloon catheter to improve coronary and cerebral blood flow during SECPR, aortic flush techniques and a double-balloon aortic catheter that could allow separate perfusion (and cooling) of the heart, brain and viscera for optimal resuscitation of each. Decision-making, initiation of UALS methods and diagnostic evaluations must be rapid to maximize the potential for ROSC and facilitate decision-making regarding long-term circulatory support versus withdrawal of life support for hopeless cases. Research and development of UALS technique needs to be coordinated with cerebral resuscitation research. Copyright © 1997 Elsevier Science Ireland Ltd.</div></front></TEI><affiliations><list><country><li>Belgique</li><li>Japon</li><li>États-Unis</li></country><region><li>Missouri (État)</li><li>Ohio</li><li>Pennsylvanie</li><li>Région de Bruxelles-Capitale</li></region><settlement><li>Bruxelles</li><li>Pittsburgh</li></settlement><orgName><li>Université de Pittsburgh</li></orgName></list><tree><country name="États-Unis"><region name="Pennsylvanie"><name sortKey="Tisherman, S A" sort="Tisherman, S A" uniqKey="Tisherman S" first="S. A." last="Tisherman">S. A. Tisherman</name></region><name sortKey="Buckman, R F" sort="Buckman, R F" uniqKey="Buckman R" first="R. F." last="Buckman">R. F. Buckman</name><name sortKey="Grenvik, A" sort="Grenvik, A" uniqKey="Grenvik A" first="A." last="Grenvik">A. Grenvik</name><name sortKey="Obrist, W" sort="Obrist, W" uniqKey="Obrist W" first="W." last="Obrist">W. Obrist</name><name sortKey="Rubertsson, S" sort="Rubertsson, S" uniqKey="Rubertsson S" first="S." last="Rubertsson">S. Rubertsson</name><name sortKey="Safar, P" sort="Safar, P" uniqKey="Safar P" first="P." last="Safar">P. Safar</name><name sortKey="Stephenson, H E" sort="Stephenson, H E" uniqKey="Stephenson H" first="H. E." last="Stephenson">H. E. Stephenson</name><name sortKey="White, R J" sort="White, R J" uniqKey="White R" first="R. J." last="White">R. J. White</name></country><country name="Belgique"><noRegion><name sortKey="Vandevelde, K" sort="Vandevelde, K" uniqKey="Vandevelde K" first="K." last="Vandevelde">K. Vandevelde</name></noRegion><name sortKey="Corne, L" sort="Corne, L" uniqKey="Corne L" first="L." last="Corne">L. Corne</name></country><country name="Japon"><noRegion><name sortKey="Morioka, T" sort="Morioka, T" uniqKey="Morioka T" first="T." last="Morioka">T. Morioka</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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