[New aspects and perspectives on cardiac arrest].
OBJECTIVE
To analyse the current knowledge based on the experimental and the clinical research studies focused on the main fields of cardiopulmonary resuscitation.


METHODS
International guidelines and recent review articles. Data collected from the Medline database with the key word: cardiac arrest.


METHODS
Research studies published during the last ten years were reviewed. Relevant clinical information was extracted and discussed when it induced changes in guidelines.


RESULTS
Promising improvements on basic and advanced life supports are proposed. Chest compressions prevail over ventilation. Alternatives to classical chest compressions are tested. Ventilatory volume must be reduced from 1000 to approximatively 500 mL for each breath with oxygen. Biphasic waveform defibrillators and automated external defibrillators will be considered as the best devices in the near future. Some non-catecholaminergic vasopressors could reduce the use of epinephrine for advanced cardiac life support. Lidocaine could be replaced by amiodarone as anti-arrhythmic drug of choice. New post-resuscitation therapeutic strategies are evaluated, especially coronary reperfusion when the cause of cardiac arrest is cardiac.


CONCLUSIONS
Many fields of cardiopulmonary resuscitation are investigated. Some relevant informations are included in the last international guidelines published in 2000, but most of them need complementary studies before other changes could be recommended for routine practice.
Départements d'anesthésie-réanimation et Samu de Lyon, CHU Lyon-Sud, France. pierre-yves.gueugniaud@chu-lyon.fr
P Y
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Gueugniaud
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JS
David
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Carli
D016887:Cardiopulmonary Resuscitation; D004554:Electric Countershock; D005602:France; D017408:Guidelines as Topic; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans