• Kuvaaja: Juha Jormakka
  • Kuvaaja: Juha Jormakka
  • Kuvaaja: Juha Jormakka
  • Kuvaaja: Juha Jormakka
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Lähteet Systole 3/2009


Kylmäksi kentällä
- Terapeuttisen hypotermian aloitus sairaalan ulkopuolella
Teksti Antti Kämäräinen

- Abella BS, Zhao D, Alvarado J, Hamann K, Vanden Hoek TL and Becker LB (2004): Intra-arrest cooling improves outcomes in a murine cardiac arrest model. Circulation 109: 2786-91.
- Alzaga AG, Cerdan M and Varon J (2006): Therapeutic hypothermia. Resuscitation 70: 369-380.
- Bernard SA, Gray TW, Buist MD, Jones BM, Silvester W, Gutteridge G and Smith K (2002): Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. New England Journal of Medicine 346: 557-63.
- Bruel C, Parienti JJ, Marie W, Arrot X, Daubin C, Du Cheyron D, Massetti M and Charbonneau P (2008): Mild hypothermia during advanced life support: a preliminary study in out-of-hospital cardiac arrest. Critical Care 12: R31.
- Castrén M, Silfvast T, Rubertsson S, Niskanen M, Valsson F, Wanscher M and Sunde K (2009): Scandinavian Clinical practice guidelines for therapeutic hypothermia and post-resuscitation care after cardiac arrest. Acta Anaesthesiologica Scandinavica 53: 280-288.
- ERC (2005): European Resuscitation Council Guidelines for Resuscitation 2005. Resuscitation 67: S1—S190.
- HACA (2002): Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. New England Journal of Medicine 346: 549-56.
- Kim F, Olsufka M, Longstreth WT, Jr., Maynard C, Carlbom D, Deem S, Kudenchuk P, Copass MK and Cobb LA (2007): Pilot randomized clinical trial of prehospital induction of mild hypothermia in out-of-hospital cardiac arrest patients with a rapid infusion of 4 degrees C normal saline. Circulation 115: 3064-70.
- Kliegel A, Janata A, Wandaller C, Uray T, Spiel A and Losert H (2007): Cold infusions alone are effective for induction of therapeutic hypothermia but do not keep patients cool after cardiac arrest. Resuscitation 73: 46-53.
- Kuboyama K, Safar P, Radovsky A, Tisherman SA, Stezoski SW, Alexander H (1993): Delay in cooling negates the beneficial effect of mild resuscitative cerebral hypothermia after cardiac arrest in dogs: a prospective, randomized study. Critical Care Medicine 21: 1348-58.
- Kämäräinen A, Virkkunen I, Tenhunen J, Yli-Hankala A and Silfvast T (2008): Induction of therapeutic hypothermia during prehospital CPR using ice-cold intravenous fluid. Resuscitation 79:205-211.
- Kämäräinen A, Virkkunen I, Tenhunen J, Yli-Hankala A and Silfvast T (2009): Prehospital therapeutic hypothermia for comatose survivors of cardiac arrest – A randomized controlled trial. Acta Anaesthesiologica Scandinavica (in press).
- Oksanen T, Pettilä V, Hynynen M and Varpula T (2007): Therapeutic hypothermia after cardiac arrest: implementation and outcome in Finnish intensive care units. Acta Anaesthesiol Scand 51: 866-871.

Mihin hävisivät kammiovärinäpotilaat?
Teksti Heini Harve

(1)    Kuisma M, Repo J, Alaspää A. The incidence of out-of-hospital ventricular fibrillation in Helsinki, Finland, from 1994 to 1999. Lancet 2001; 358: 473–74.
(2)    Herlitz J, Andersson E, Bang A, et al. Experiences from treatment of out-of-hospital cardiac arrest during 17 years in Goteborg. Eur Heart J 2000; 21: 1251–58.
(3)    Cobb LA, Fahrenbruch CE, Olsufka M, Copass MK. Changing incidence of out-of-hospital ventricular fibrillation, 1980-2000. JAMA 2002;288:3008-3013.
(4)    Polentini MS, Pirrallo RG, McGill W. The changing incidence of ventricular fibrillation in Milwaukee, Wisconsin (1992-2002). Prehosp Emerg Care 2006; 10:52-60.
(5)    A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. The Antiarrhythmics versus Implantable Defibrillators (AVID) Investigators. N Engl J Med 1997;337:1576-83.
(6)    Wang H, Tang W, Ristagno G, Li Y, Sun S, Wang T, et al. The potential mechanisms of reduced incidence of ventricular fibrillation as the presenting rhythm in sudden cardiac arrest. Crit Care Med 2009;37:26-31.
(7)    Youngquist ST, Kaji AH, Niemann JT. Beta-blocker use and the changing epidemiology of out-of-hospital cardiac arrest rhythms. Resuscitation 2008;76:376-80.
(8)    Huikuri HV, Castellanos A, Myerburg R. Sudden death due to cardiac arrhythmias. N Engl J Med 2001;345:1473-82.
(9)    Bigger JT: Relation between left ventricular dysfunction and ventricular arrhythmias after myocardial infarction. Am J Cardiol 1986;57(suppI B):8B-14B.
(10)    European Resuscitation Council. European Resuscitation Council Guidelines for Resuscitation 2005. Resuscitation 2005;67:S1.
(11)    Movahed MR, Hashemzadeh M, Jamal M. Increased prevalence of ventricular fibrillation in patients with type 2 diabetes mellitus. Heart Vessels 2007;22:251-3.
(12)    Eisenburger P, Sterz F, Haugk M, Scheinecker W, Holzer M, Koreny M, et al. Cardiac arrest in public locations--an independent predictor for better outcome? Resuscitation 2006;70:395-403.
(13)    Colquhoun MC, Chamberlain DA, Newcombe RG, Harris R, Harris S, Peel K, et al. A national scheme for public access defibrillation in England and Wales: early results. Resuscitation 2008;78:275-80.
(14)    Valenzuela TD, Roe DJ, Nichol G, Clark LL, Spaite DW, Hardman RG. Outcomes of rapid defibrillation by security officers after cardiac arrest in casinos. N Engl J Med 2000;343:1206-9.
(15)    Caffrey SL, Willoughby PJ, Pepe PE, Becker LB. Public use of automated external defibrillators. N Engl J Med 2002;347:1242-7.
(16)    van Alem AP, Waalewijn RA, Koster RW, de Vos R. Assessment of quality of life and cognitive function after out-of-hospital cardiac arrest with successful resuscitation. Am J Cardiol 2004b;93:131-135.
(17)    van Alem AP, de Vos R, Schmand B, Koster RW. Cognitive impairment in survivors of out-of-hospital cardiac arrest. Am Heart J 2004a;148:416-421.
(18)    Horsted TI, Rasmussen LS, Meyhoff CS, Nielsen SL. Long-term prognosis after out-of-hospital cardiac arrest. Resuscitation 2007;72:214-218.

Hätäkeskuspäivystäjä sydänpysähdyspotilaan hoitoketjussa
Teksti Heini Harve

1. European Resuscitation Council. European Resuscitation Council Guidelines for Resuscitation 2005. Resuscitation 2005(67):S1.
2. Kuisma M, Boyd J, Vayrynen T, Repo J, Nousila-Wiik M, Holmstrom P. Emergency call processing and survival from out-of-hospital ventricular fibrillation. Resuscitation 2005 Oct;67(1):89-93.3. Bang A, Herlitz J, Martinell S. Interaction between emergency medical dispatcher and caller in suspected out-of-hospital cardiac arrest calls with focus on agonal breathing. A review of 100 tape recordings of true cardiac arrest cases. Resuscitation 2003 Jan;56(1):25-34.
4. Nurmi J, Pettila V, Biber B, Kuisma M, Komulainen R, Castren M. Effect of protocol compliance to cardiac arrest identification by emergency medical dispatchers. Resuscitation 2006 Sep;70(3):463-9.
5. Hallstrom A, Cobb L, Johnson E, Copass M. Cardiopulmonary resuscitation by chest compression alone or with mouth-to-mouth ventilation. N Engl J Med 2000 May 25;342(21):1546-53.
6. Heward A, Damiani M, Hartley-Sharpe C. Does the use of the Advanced Medical Priority Dispatch System affect cardiac arrest detection? Emerg Med J 2004 Jan;21(1):115-8.
7. Cairns KJ, Hamilton AJ, Marshall AH, Moore MJ, Adgey AA, Kee F. The obstacles to maximising the impact of public access defibrillation: an assessment of the dispatch mechanism for out-of-hospital cardiac arrest. Heart 2008 Mar;94(3):349-53.
8. Hallstrom AP, Cobb LA, Johnson E, Copass MK. Dispatcher assisted CPR: implementation and potential benefit. A 12-year study. Resuscitation 2003 May;57(2):123-9.
9. Hauff SR, Rea TD, Culley LL, Kerry F, Becker L, Eisenberg MS. Factors impeding dispatcher-assisted telephone cardiopulmonary resuscitation. Ann Emerg Med 2003 Dec;42(6):731-7.
10. Rea TD, Eisenberg MS, Culley LL, Becker L. Dispatcher-assisted cardiopulmonary resuscitation and survival in cardiac arrest. Circulation 2001 Nov 20;104(21):2513-6.
11. Dorph E, Wik L, Steen PA. Dispatcher-assisted cardiopulmonary resuscitation. An evaluation of efficacy amongst elderly. Resuscitation 2003 Mar;56(3):265-73.
12. Williams JG, Brice JH, De Maio VJ, Jalbuena T. A simulation trial of traditional dispatcher-assisted CPR versus compressions--only dispatcher-assisted CPR. Prehosp Emerg Care 2006 Apr-Jun;10(2):247-53.
13. Woollard M, Smith A, Whitfield R, Chamberlain D, West R, Newcombe R, et al. To blow or not to blow: a randomised controlled trial of compression-only and standard telephone CPR instructions in simulated cardiac arrest. Resuscitation 2003 Oct;59(1):123-31.
14. Harve H, Jokela J, Tissari A, Saukko A, Rasanen P, Okkolin T, et al. Can untrained laypersons use a defibrillator with dispatcher assistance? Acad Emerg Med 2007 Jul;14(7):624-8.
15. Harve H, Jokela J, Tissari A, Saukko A, Okkolin T, Pettila V, et al. Defibrillation and the quality of layperson cardiopulmonary resuscitation-dispatcher assistance or training? Resuscitation 2009 Feb;80(2):275-7.
16. Perkins GD, Boyle W, Bridgestock H, Davies S, Oliver Z, Bradburn S, et al. Quality of CPR during advanced resuscitation training. Resuscitation 2008 Apr;77(1):69-74.
17. Verplancke T, De Paepe P, Calle PA, De Regge M, Van Maele G, Monsieurs KG. Determinants of the quality of basic life support by hospital nurses. Resuscitation 2008 Apr;77(1):75-80.
18. Johnsen E, Bolle SR. To see or not to see--better dispatcher-assisted CPR with video-calls? A qualitative study based on simulated trials. Resuscitation 2008 Sep;78(3):320-6.
19. Bolle SR, Scholl J, Gilbert M. Can video mobile phones improve CPR quality when used for dispatcher assistance during simulated cardiac arrest? Acta Anaesthesiol Scand 2009 Jan;53(1):116-20.
20. Ecker R, Rea TD, Meischke H, Schaeffer SM, Kudenchuk P, Eisenberg MS. Dispatcher assistance and automated external defibrillator performance among elders. Acad Emerg Med 2001 Oct;8(10):968-73.

Elvytetyn potilaan ROSC:n jälkeinen ensihoito sairaalan ulkopuolella
- artikkeli opinnäytetyön pohjalta
Teksti Johanna Bowles, Emmi Salminen

1) Käypä hoito -suositukset, 29.12.2006 [viitattu 5.5.2007], http://www.kaypahoito.fi/.
2) Kuisma, M. 2004. Sydänpysähdys ja elvytys. Elvytyksen jälkeinen hoito. Teoksessa Alaspää, A., Kuisma, M., Rekola, L., Sillanpää, K. (toim.) 2004. Uusi Ensihoidon käsikirja. Tammi: Helsinki, 206-208;
3) Elomaa, T. (anest. erikoislääkäri) 2004. Elvytetyn potilaan viilennyshoito, Suomen ensihoi-toalanliitto, 1/2004 [viitattu 5.5.2007], http://www.sehl.fi/ensihoitajalehti/lehdet/numero_1_2004/elvytetyn_potilaan_viilennyshoit/.
4) Tanskanen, P. 2004. Vammapotilas. Aivovammapotilaan ensihoito. Teoksessa Alaspää, A., Kuisma, M., Rekola, L., Sillanpää, K. (toim.) 2004. Uusi Ensihoidon käsikirja. Tammi: Helsinki, 335, 339-341.
5) Randell, T. & Öhman, J. 2001. Tajuton potilas ei koskaan hengitä ”hyvin”. Finnanest. Vol. 34:1 (33).
6)Schwarz, S., Schwab, S., Bertram, M., Aschoff, A. & Hacke, W. 1998. Effects of hypertonic sa-line hydroxyethyl starch solution and mannitol in patients with increased intracranial pressure after stroke. Stroke. 29:1550-1555.9) Voipio, V., & Kuisma, M. 2000. Ensihoito. Elvytyksen jälkeinen hoito. Duodecim. 116(10):1142-1149.
7) Schwarz, S., Georgiadis, D., Aschoff, A. & Schwab, S. 2002. Effects of hypertonic (10 %) saline in patients with raised intracranial pressure after stroke. Stroke. 33:136-140.
8) Noppens, R., Christ, M., Brambrink, A., Koerner, I., Heimann, A., Kempski. 2006. An early bo-lus of hypertonic saline hydroxyethyl starch improves long-term outcome after global cerebral ischemia. Critical Care Medicine. 34(8):2194-2200, August 2006.
9) Voipio, V., & Kuisma, M. 2000. Ensihoito. Elvytyksen jälkeinen hoito. Duodecim. 116(10):1142-1149.
10)Virkkunen, I., Yli-Hankala, A., Silvfast, T. Induction of therapeutic hypothermia after cardiac arrest in prehospital patients using ice-cold Ringer´s solution: a pilot study. Resuscitation; Official Journal of the European Resuscitation Council. 62(3):299-302), September 2004.
11) Liu, Y., Rosenthal, R., Haywood, Y., Miljkovic-Lolic, M., Vanderhoek, J., Fiskum, G. 1998. Normoxic Ventilation After Cardiac Arrest Reduces Oxidation of Brain Lipids and Improves Neu-rological Outcome. Stroke. 29(8):1679-1686, August 1998.
12) Kirves, H., Skrifvars, M., Vähäkuopus, M., Ekström, K., Martikainen, M., Castrén, M. Adher-ence to resuscitation guidelines during prehospital care of cardiac arrest patients. European Journal of Emergency Medicine. 14(2):75-81, April 2007.


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