Annals of Emergency Medicine
Volume 52, Issue 3 , Pages 244-252 , September 2008

Cardiocerebral Resuscitation Improves Neurologically Intact Survival of Patients With Out-of-Hospital Cardiac Arrest

Presented at the 2007 American Heart Association meeting, November 2007, Orlando, FL.

  • Michael J. Kellum, MD

      Affiliations

    • Departments of Emergency Medicine at Mercy Health System, Janesville, WI
    • Corresponding Author InformationAddress for reprints: Michael J. Kellum, MD, W9675 Homburg Ln, Whitewater, WI 53190; 262-949-2270, fax 262-245-2303
  • ,
  • Kevin W. Kennedy, MS

      Affiliations

    • Departments of Emergency Medicine at Mercy Health System, Janesville, WI
  • ,
  • Richard Barney, MD

      Affiliations

    • Department of Emergency Medicine, Beloit Memorial Hospital, Beloit, WI
  • ,
  • Franz A. Keilhauer, MD

      Affiliations

    • Departments of Emergency Medicine at Mercy Health System, Janesville, WI
  • ,
  • Michael Bellino, MD

      Affiliations

    • Aurora Lakeland Medical Center, Elkhorn, WI
  • ,
  • Mathias Zuercher, MD

      Affiliations

    • University of Arizona Sarver Heart Center, University of Arizona College of Medicine, Tucson, AZ
    • University of Basel, Basel, Switzerland
  • ,
  • Gordon A. Ewy, MD

      Affiliations

    • University of Arizona Sarver Heart Center, University of Arizona College of Medicine, Tucson, AZ

Received 4 October 2007 ,Revised 10 December 2007 ,Accepted 7 February 2008.

References 

  1. State-specific mortality from sudden cardiac death—United States, 1999. MMWR Morb Mortal Wkly Rep. 2002;51:123–126
  2. Zheng ZJ, Croft JB, Giles WH, et al. Sudden cardiac death in the United States, 1989 to 1998. Circulation. 2001;104:2158–2163
  3. Rea TD, Eisenberg MS, Sinibaldi G, et al. Incidence of EMS-treated out-of-hospital cardiac arrest in the United States. Resuscitation. 2004;63:17–24
  4. Engdahl J, Bang A, Lindqvist J, et al. Time trends in long-term mortality after out-of-hospital cardiac arrest, 1980 to 1998, and predictors for death. Am Heart J. 2003;145:826–833
  5. Rea TD, Eisenberg MS, Becker LJ, et al. Temporal trends in sudden cardiac arrest: a 25-year emergency medical services perspective. Circulation. 2003;107:2780–2785
  6. Ewy GA. Cardiocerebral resuscitation: the new cardiopulmonary resuscitation. Circulation. 2005;111:2134–2142
  7. Kern KB, Valenzuela TD, Clark LL, et al. An alternative approach to advancing resuscitation science. Resuscitation. 2005;64:261–268
  8. Ewy GA. A new approach for out-of-hospital CPR: a bold step forward. Resuscitation. 2003;58:271–272
  9. Sanders AB, Kern KB, Atlas M, et al. Importance of the duration of inadequate coronary perfusion pressure on resuscitation from cardiac arrest. J Am Coll Cardiol. 1985;6:113–118
  10. Kern KB, Ewy GA, Voorhees WD, et al. Myocardial perfusion pressure: a predictor of 24-hour survival during prolonged cardiac arrest in dogs. Resuscitation. 1988;16:241–250
  11. Berg RA, Kern KB, Sanders AB, et al. Bystander cardiopulmonary resuscitation (Is ventilation necessary?). Circulation. 1993;88:1907–1915
  12. Berg RA, Wilcoxson D, Hilwig RW, et al. The need for ventilatory support during bystander CPR. Ann Emerg Med. 1995;26:342–350
  13. Berg RA, Kern KB, Hilwig RW, et al. Assisted ventilation during “bystander” CPR in a swine acute myocardial infarction model does not improve outcome. Circulation. 1997;96:4364–4371
  14. Berg RA, Kern KB, Hilwig RW, et al. Assisted ventilation does not improve outcome in a porcine model of single-rescuer bystander cardiopulmonary resuscitation. Circulation. 1997;95:1635–1641
  15. Kellum MJ. Call and pump. http://www.callandpump.orgAccessed March 12, 2008
  16. Kellum MJ, Kennedy KW, Ewy GA. Cardiocerebral resuscitation improves survival of patients with out-of-hospital cardiac arrest. Am J Med. 2006;119:335–340
  17. Campbell JP, Maxey VA, Watson WA. Hawthorne effect: implications for prehospital research. Ann Emerg Med. 1995;26:590–594
  18. Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care (Part 1: Introduction to the international guidelines 2000 for CPR and ECC: a consensus on science). Circulation. 2000;102:I-44
  19. American Heart Association. guidelines for cardiopulmonary resuscitation and emergency medical services for out-of-hospital cardiac arrest. Part 7.2: management of cardiac arrest. Circulation. 2005;112:IV-58
  20. Cummins RO, Chamberlain DA, Abramson NS, et al. Recommended guidelines for uniform reporting of data from out-of-hospital cardiac arrest: the Utstein style (A statement for health professionals from a task force of the American Heart Association, the European Resuscitation Council, the Heart and Stroke Foundation of Canada, and the Australian Resuscitation Council). Circulation. 1991;84:960–975
  21. Herlitz J, Bang A, Ekstrom L, et al. A comparison between patients suffering in-hospital and out-of-hospital cardiac arrest in terms of treatment and outcome. J Intern Med. 2000;248:53–60
  22. Kern KB. Limiting interruptions of chest compressions during cardiopulmonary resuscitation. Resuscitation. 2003;58:273–274
  23. Stiell IG, Wells GA, Field B, et al. Advanced cardiac life support in out-of-hospital cardiac arrest. N Engl J Med. 2004;351:647–656
  24. Bobrow BJ, Clark L, Ewy GA, et al. Minimally interrupted cardiac resuscitation by emergency medical services for out-of-hospital cardiac arrest. JAMA. 2008;299:1158–1165
  25. Polentini MS, Pirrallo RG, McGill W. The changing incidence of ventricular fibrillation in Milwaukee, Wisconsin (1992-2002). Prehosp Emerg Care. 2006;10:52–60
  26. Weisfeldt ML, Becker LB. Resuscitation after cardiac arrest: a 3-phase time-sensitive model. JAMA. 2002;288:3035–3038
  27. Andreka P, Frenneaux MP. Haemodynamics of cardiac arrest and resuscitation. Curr Opin Crit Care. 2006;12:198–203
  28. Hsu JW, Madsen CD, Callaham ML. Quality-of-life and formal functional testing of survivors of out-of-hospital cardiac arrest correlates poorly with traditional neurologic outcome scales. Ann Emerg Med. 1996;28:597–605
  29. Ewy GA, Kellum MJ, Kern KB. Cardiocerebral resuscitation: a better approach to out-of-hospital cardiac arrest. In: Yearbook Intensive Care Emerg Med. Heidelberg, Berlin: Springer-Verlag; 2006;p. 316–327
  30. Ewy GA, Kellum MJ. Cardiocerebral resuscitation: a new approach to out-of-hospital cardiac arrest. In:  Paradis N,  Halperin H,  Kern K, et al. editor. Cardiac Arrest: The Science and Practice of Resuscitation Medicine. 2nd ed. New York, NY: Cambridge University Press; 2007;p. 747–756

 Supervising editor: Theodore R. Delbridge, MD, MPHAuthor contributions: MJK, KWK, RB, FAK, MB, and GAE participated in development of the out-of-hospital protocol. MJK and KWK were responsible for data collection. Training and supervision of participants was done by MJK, KWK, RB, FAK, and MB. MZ provided statistical analysis. MJK and GAE drafted the article, and all authors participated in its revisions. MJK had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. MJK takes responsibility for the paper as a whole.Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. The authors have stated that no such relationships exist. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement.Publication dates: Available online March 28, 2008.

PII: S0196-0644(08)00486-1

doi: 10.1016/j.annemergmed.2008.02.006

Annals of Emergency Medicine
Volume 52, Issue 3 , Pages 244-252 , September 2008