Annals of Emergency Medicine
Volume 28, Issue 5 , Pages 527-541 , November 1996

Utstein-Style Guidelines for Uniform Reporting of Laboratory CPR Research: A Statement for Health Care Professionals From a Task Force of the American Heart Association, the American College of Emergency Physicians, the American College of Cardiology, the European Resuscitation Council, the Heart and Stroke Foundation of Canada, the Institute of Critical Care Medicine, the Safar Center for Resuscitation Research, and the Society for Academic Emergency Medicine

References 

  1. Niemann JT. Study design in cardiac arrest research: Moving from the laboratory to the clinical population [editorial]. Ann Emerg Med. 1993;22:8–10
  2. Yealy DM. How much "significance" is significant? The transition from animal models to human trials in resuscitation research. Ann Emerg Med. 1993;22:11–16
  3. Emergency Cardiac Care Committee, ACLS and BLS Subcommittees, American Heart Association . Guidelines for cardiopulmonary resuscitation and emergency cardiac care. JAMA. 1992;268:2171–2302
  4. Lindner KH, Ahnefeld FW, Bowdler IM. Comparison of different doses of epinephrine on myocardial perfusion and resuscitation success during cardiopulmonary resuscitation in a pig model. Am J Emerg Med. 1991;9:27–31
  5. Stiell IG, Hebert PC, Weitzman BN, et al.  High-dose epinephrine in adult cardiac arrest. N Engl J Med. 1992;327:1045–1050
  6. Brown CG, Martin DR, Pepe PE, et al.  A comparison of standard-dose and high-dose epinephrine in cardiac arrest outside the hospital: The Multicenter High-Dose Epinephrine Study Group. N Engl J Med. 1992;327:1051–1055
  7. Callaham M, Madsen CD, Barton CW, et al.  A randomized clinical trial of high-dose epinephrine and norepinephrine versus standard-dose epinephrine in prehospital cardiac arrest [abstract]. Ann Emerg Med. 1992;21:606–607
  8. Weisfeldt ML, Guerci AD. Sodium bicarbonate in CPR [editorial]. JAMA. 1991;266:2129–2130
  9. Eisenberg MS, Cummins RO, Damon S, et al.  Survival rates from out-of-hospital cardiac arrest: Recommendations for uniform definitions and data to report. Ann Emerg Med. 1990;19:1249–1259
  10. 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
  11. Idris AH, Becker LB, Wenzel V, et al.  Lack of uniform definitions and reporting in laboratory models of cardiac arrest: A review of the literature and a proposal for guidelines. Ann Emerg Med. 1994;23:9–16
  12. Aitkenhead AR, Bahr SJ, Cavaliere F, et al.  Animal research in cardiopulmonary resuscitation: Revised recommendations of a working party of the European Academy of Anaesthesiology. Eur J Anaesthiol. 1990;7:83–87
  13. Tsitlik JE, Levin HR, Halperin HR. Measurements in cardiopulmonary resuscitation research. In:  Paradis N,  Halperin HR,  Nowak RM editor. Cardiac Arrest: The Science and Practice of Resuscitation Medicine. Philadelphia: Williams & Wilkins; 1996;p. 218–238
  14. Kern KB, Hilwig R, Ewy GA. Retrograde coronary blood flow during cardiopulmonary resuscitation in swine: Intracoronary Doppler evaluation. Am Heart J. 1994;128:490–499
  15. Weil MH, Houle DB, Brown EB, et al.  Influence of acidosis on the effectiveness of vasopressor agents. Circulation. 1957;16:949
  16. Campbell GS, Houle DB, Crisp NW, et al.  Depressed response to intravenous sympathicomimetic agents in human acidosis. Dis Chest. 1958;33:18–22
  17. Sechzer PH, Egbert LD, Linde HW, et al.  Effect of CO2 inhalation on arterial pressure, ECG and plasma catecholamines and 17-OH corticosteroids in normal man. J Appl Physiol. 1960;15:454–458
  18. Köhler E, Noack E, Strobach H, et al.  Effect of respiratory acidosis on heart and circulation in cats, pigs, dogs and rabbits. Res Exp Med (Berl). 1972;158:308–320
  19. Bendixen HH, Laver MB, Flacke WE. Influence of respiratory acidosis on circulatory effect of epinephrine in dogs. Circ Res. 1963;13:64–70
  20. Manley ES, Woodbury RA, Nash CB. Cardiovascular responses to epinephrine during acute hypercapnia in dogs: Effects of autonomic blocking drugs. Circ Res. 1966;18:573–584
  21. Houle DB, Weil MH, Brown EB, et al.  Influence of respiratory acidosis on ECG and pressor responses to epinephrine, norepinephrine and metaraminol. Proc Soc Exp Biol Med. 1957;94:561–564
  22. Campbell GS, Houle DB, Crisp NW, et al.  Depressed response to intravenous sympathicomimetic agents in human acidosis. Dis Chest. 1958;33:18–22
  23. Bowman TA, Hughes HC. Swine as an in vivo model for electrophysiologic evaluation of cardiac pacing parameters. Pacing Clin Electrophysiol. 1984;7:187–194
  24. Howe BB, Sehn PA, Pensinger RR. Comparative anatomical studies of canine and porcine hearts. Acta Anat. 1968;71:13–21
  25. Gardner TJ, Johnson DL. Cardiovascular system. In:  Swindle MM,  Adams RJ editor. Experimental Surgery and Physiology: Induced Animal Models of Human Disease. Baltimore: Williams & Wilkins; 1988;p. 74–114
  26. In:  Fox JG,  Cohen BJ,  Loew FM editor. Laboratory Animal Medicine. New York: Academic Press; 1984;
  27. von Planta I, Weil MH, von Planta M, et al.  Cardiopulmonary resuscitation in the rat. J Appl Physiol. 1988;65:2641–2647
  28. Swindle MM, Smith AC, Hepburn BJS. Swine as models in experimental surgery. J Invest Surg. 1988;1:65–79
  29. Smith AC, Spinale FG, Swindle MM. Cardiac function and morphology of Hanford miniature swine and Yucatan miniature and micro swine. Lab Anim Sci. 1990;40:47–50
  30. Kohn DH, Wixson SK, White WJ, et al (eds): Anesthesia and Analgesia in Research Animals. New York: Academic Press, in press.
  31. In:  Smith AC,  Swindle MM editor. Research Animal Anesthesia, Analgesia, and Surgery. Bethesda, Maryland: Scientists Center for Animal Welfare; 1994;
  32. Carlsson C, Hägerdal M, Kaasik AE, et al.  A catecholamine-mediated increase in cerebral oxygen uptake during immobilization stress in rats. Brain Res. 1977;119:223–231
  33. Winkle RA, Mead RH, Ruder MA, et al.  Effect of duration of ventricular fibrillation on defibrillation efficacy in humans. Circulation. 1990;81:1477–1481
  34. Eisenberg M, Hallstrom A, Bergner L. The ACLS score: Predicting survival from out-of-hospital cardiac arrest. JAMA. 1981;246:50–52
  35. Weaver WD, Cobb LA, Hallstrom AP, et al.  Factors influencing survival after out-of-hospital cardiac arrest. J Am Coll Cardiol. 1986;7:752–757
  36. 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
  37. Gremels H, Starling EH. On the influence of hydrogen ion concentration and of anoxaemia upon the heart volume. J Physiol (Lond). 1926;61:297–304
  38. Jacobus WE, Pores IH, Lucas SK, et al.  Intracellular acidosis and contractility in the normal and ischemic heart as examined by 31P NMR. J Mol Cell Cardiol. 1982;14(suppl 3):13–20
  39. Monroe RG, French G, Whittenberger JL. Effects of hypocapnia and hypercapnia on myocardial contractility. Am J Physiol. 1960;199:1121–1124
  40. Tyberg JV, Yeatman LA, Parmley WW, et al.  Effects of hypoxia on mechanics of cardiac contraction. Am J Physiol. 1970;218:1780–1788
  41. Becker LB, Idris AH, Shao Z, et al.  Inhibition of cardiomyocyte contractions by carbon dioxide [abstract]. Circulation. 1993;88(suppl 1):I-225
  42. Orchard CH, Kentish JC. Effects of changes of pH on the contractile function of cardiac muscle. Am J Physiol. 1990;258:C967–C981
  43. Kette F, Weil MH, Gazmuri RJ, et al.  Intramyocardial hypercarbic acidosis during cardiac arrest and resuscitation. Crit Care Med. 1993;21:901–906
  44. Grum CM. Tissue oxygenation in low flow states and during hypoxemia. Crit Care Med. 1993;21(suppl):S44–S49
  45. Idris AH, Staples ED, O'Brien DJ, et al.  Effect of ventilation on acid-base balance and oxygenation in low blood-flow states. Crit Care Med. 1994;22:1827–1834
  46. Fuerst RS, Idris AH, Banner MJ, et al.  Changes in respiratory system compliance during cardiopulmonary arrest with and without closed chest compressions [abstract]. Ann Emerg Med. 1993;22:931
  47. Ornato JP, Bryson BL, Donovan PJ, et al.  Measurement of ventilation during cardiopulmonary resuscitation. Crit Care Med. 1983;11:79–82
  48. Kerber RE, Grayzel J, Hoyt R, et al.  Transthoracic resistance in human defibrillation. Influence of body weight, chest size, serial shocks, paddle size, and paddle contact pressure. Circulation. 1981;63:676–682
  49. Niemann JT, Criley JM, Rosborough JP, et al.  Predictive indices of successful cardiac resuscitation after prolonged arrest and experimental cardiopulmonary resuscitation. Ann Emerg Med. 1985;14:521–528
  50. Niemann JT, Rosborough JP, Ung S, et al.  Coronary perfusion pressure during experimental cardiopulmonary resuscitation. Ann Emerg Med. 1982;11:127–131
  51. 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
  52. Paradis NA, Martin GB, Rivers EP, et al.  Coronary perfusion pressure and the return of spontaneous circulation in human cardiopulmonary resuscitation. JAMA. 1990;263:1106–1113
  53. Ganz W, Swan HJC. Measurement of blood flow by thermodilution. Am J Cardiol. 1972;29:241–246
  54. Geddes LA, Babbs CF. A new technique for repeated measurement of cardiac output during cardiopulmonary resuscitation. Crit Care Med. 1980;8:131–133
  55. Brown CG, Katz SE, Werman HA, et al.  The effect of epinephrine versus methoxamine on regional myocardial blood flow and defibrillation rates following a prolonged cardiorespiratory arrest in a swine model. Am J Emerg Med. 1987;5:362–369
  56. Koehler RC, Chandra N, Guerci AD, et al.  Augmentation of cerebral perfusion by simultaneous chest compression and lung inflation with abdominal binding after cardiac arrest in dogs. Circulation. 1983;67:266–275
  57. Safar P. Long-term animal outcome models for cardiopulmonary-cerebral resuscitation research. Crit Care Med. 1985;13:936–940
  58. Safar P. Prevention and therapy of postresuscitation neurologic dysfunction and injury. In:  Paradis NA,  Halperin HR,  Nowak RM editor. Cardiac Arrest: The Science and Practice of Resuscitation Medicine. Philadelphia: Williams & Wilkins; 1996;p. 859–887
  59. Gisvold SE, Safar P, Rao G, et al.  Multifaceted therapy after global brain ischemia in monkeys. Stroke. 1984;15:803–812
  60. Bircher N, Safar P. Cerebral preservation during cardiopulmonary resuscitation. Crit Care Med. 1985;13:185–190
  61. Sterz F, Safar P, Tisherman S, et al.  Mild hypothermic cardiopulmonary resuscitation improves outcome after prolonged cardiac arrest in dogs. Crit Care Med. 1991;19:379–389
  62. Safar P, Abramson NS, Angelos M, et al.  Emergency cardiopulmonary bypass for resuscitation from prolonged cardiac arrest. Am J Emerg Med. 1990;8:55–67
  63. Sterz F, Leonov Y, Safar P, et al.  Hypertension with or without hemodilution after cardiac arrest in dogs. Stroke. 1990;21:1178–1184
  64. Leonov Y, Sterz F, Safar P, et al.  Mild cerebral hypothermia during and after cardiac arrest improves neurologic outcome in dogs. J Cereb Blood Flow Metab. 1990;10:57–70
  65. Radovsky A, Safar P, Sterz F, et al.  Regional prevalence and distribution of ischemic neurons in dog brains 96 hours after cardiac arrest of 0 to 20 minutes. Stroke. 1995;26:2127–2134
  66. Safar P, Xiao F, Radovsky A, et al.  Improved cerebral resuscitation from cardiac arrest in dogs with mild hypothermia plus blood flow promotion. Stroke. 1996;27:105–113
  67.  Safar P,  Ebmeyer U,  Katz L, et al.Future directions for resuscitation research. Crit Care Med. 1996;24:S1–S105
  68. Huth EJ, King K, Lock SP, et al. , for the International Committee of Medical Journal Editors   Uniform requirements for manuscripts submitted to biomedical journals. Ann Intern Med. 1988;108:258–265
  69. Huth EJ, King K, Lock SP, et al. , for the International Committee of Medical Journal Editors   Uniform requirements for manuscripts submitted to biomedical journals. N Engl J Med. 1991;324:424–428
  70. Bailar JC, Mosteller F. Guidelines for statistical reporting in articles for medical journals: Amplifications and explanations. Ann Intern Med. 1988;108:266–273
  71. Zaritsky A, Nadkarni V, Hazinski MF, et al.  Recommended guidelines for uniform reporting of pediatric advanced life support: The pediatric Utstein style: A statement for healthcare professionals from a task force of the American Academy of Pediatrics, the American Heart Association, and the European Resuscitation Council. Circulation. 1995;92:2006–2020
  72. Gallagher EJ, Lombardi G, Gennis P, et al.  Methodology-dependent variation in documentation of outcome predictors in out-of-hospital cardiac arrest. Acad Emerg Med. 1994;1:423–429
  73. Martens PR, Bahr J. A comparison of two different European EMS centers (Brugge and Gottingen) using the same electronic 'cardiopulmonary-cerebral-resuscitation' registration program: A preliminary report [letter]. Resuscitation. 1994;28:259–260
  74. Cassaccia M, Bertello F, Sicuro M, et al.  Out-of-hospital cardiac arrest in an experimental model of the management of cardiologic emergencies in a metropolitan area. G Ital Cardiol. 1995;25:127–137

☆ The Utstein-Style workshops were supported in part by grants from the American Heart Association Emergency Cardiac Care Committee and the Asmund S Laerdal Foundation for Acute Medicine.

☆☆ "Utstein-Style Guidelines for Uniform Reporting of Laboratory CPR Research" was approved by the American Heart Association Science Advisory and Coordinating Committee on June 20, 1996.

★ We give special recognistion to the participants at the three conferences for their many valuable suggestions and contributions.

★★ This statement is being published simultaneously in Circulation and Resuscitation.

♢ Address for reprints: American Heart Association Public Information 7272 Greenville Avenue Dallas, Texas 75231-4596 Fax 214-369-3685

♢♢ Single reprints are free.

PII: S0196-0644(96)70117-8

Annals of Emergency Medicine
Volume 28, Issue 5 , Pages 527-541 , November 1996

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