Cardiocerebral resuscitation: a better approach to cardiac arrest.
OBJECTIVE
To present a new approach to patients with cardiac arrest that improves neurologically normal survival. It is called cardiocerebral resuscitation (CCR), rather than cardiopulmonary resuscitation, as the major goal in cardiac arrest is to resuscitate the heart and the brain. CCR has three components: continuous chest compressions cardiopulmonary resuscitation for bystanders; a different Advanced Cardiac Life Support (ACLS) algorithm for Emergency Medical System; and a recently added aggressive postresuscitation care for resuscitated but comatose patients that includes therapeutic hypothermia and early catheterization/intervention.


RESULTS
Kellum et al. instituted the first two components of CCR in rural Wisconsin in 2004. In the subgroup of patients with a witnessed cardiac arrest and a shockable rhythm they found that neurological intact survival at hospital discharge was 15% the preceding 3 years, when the 2000 Guidelines were being followed, but 40% for the 3 years during CCR. Bobrow et al. instituted CCR for out-of-hospital cardiac arrest in metropolitan areas of Arizona and found a greater than 300% improvement (4.7-17.6%) in survival to hospital discharge of this subgroup of patients.


CONCLUSIONS
CCR improves survival of patients with cardiac arrest.
Ewy
Gordon A
GA
Section of Cardiology, University of Arizona Sarver Heart Center, University of Arizona College of Medicine, Tucson, Arizona, USA. gaewy@aol.com
D022561:Advanced Cardiac Life Support; D000465:Algorithms; D006328:Cardiac Catheterization; D016887:Cardiopulmonary Resuscitation; D035641:Chest Wall Oscillation; D004632:Emergency Medical Services; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced; D014693:Ventricular Fibrillation / Q000628:therapy*