domingo, 11 de enero de 2009

"Gasping" y Parada Cardiaca


REMI. Artículo nº 1313. Vol 8 nº 12, diciembre 2008 - Autor: Higinio Martín Hernández

Os resumo aquí un artículo muy interesante, recientemente publicado en REMI - Revista Electrónica de Medicina Intensiva, que argumenta y comenta sobre otro artículo original: Bobrow BJ, Zuercher M, Ewy GA, Clark L, Chikani V, Donahue D,. Sanders AB, Hilwig RW, Berg RA, Kern KB. Gasping During Cardiac Arrest in Humans Is Frequent and Associated With Improved Survival. Circulation 2008; 118: 2550-2554

Este trabajo viene a poner un poquito de luz (o más sombras), sobre la polémica de si se debe hacer RCP solo con las compresiones o por el contrario seguir con las pausas para respiraciones de rescate, aspecto en el que los expertos no acaban de ponerse de acuerdo.


Las últimas recomendaciones ILCOR insisten en la importancia de reducir los periodos sin compresiones durante la RCP para evitar la caida de perfusión cerebral y coronaria durante las pausas.

Por otra parte la presencia de "Gasping" o respiraciones agónicas (entendidas como cualquier respiración anormal, roncante, gorgeante, escasa, dificultosa, ruidosa o ruda), se asocian en este estudio a una mayor supervivencia en pacientes en Parada Cardiaca (en otros estudios experimentales en animales ya se mostraban efectos beneficiosos sobre el intercambio gaseoso, flujo sanguíneo cerebral, presión intracraneal y respuestas hemodinámicas asociados al "gasping").

En esta línea, es probable que en próximas guías se eliminen las ventilaciones de rescate, al menos durante los primeros minutos, para así conseguir compresiones más efectivas.


El artículo finaliza con la siguiente frase:

“comprimir fuerte, comprimir rápido y reducir al máximo las interrupciones”

Podeis consultar el artículo completo (con acceso tambien al original de la revista Circulation) desde: http://remi.uninet.edu/2008/12/REMI1313.html

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