Karl B. Kern

Low-energy biphasic waveform defibrillation: evidence-based review applied to emergency cardiovascular care guidelines: a statement for healthcare professionals from the American Heart Association Committee on Emergency Cardiovascular Care and the Subcommittees on Basic Life Support, Advanced Cardiac Life Support, and Pediatric Resuscitation.

Researchers have only recently conducted out-of-hospital human studies that document outcomes of transthoracic defibrillation using a low-energy biphasic waveform shock. The American Heart Association Committee on Emergency Cardiovascular Care (ECC) and its subcommittees included prepublication reports of these studies in this review of transthoracic biphasic waveform defibrillation. The writing group and a panel of invited experts have diligently attempted to assess the quality of the studies reviewed here by using a formal evidence-based template, which is summarized in this statement.nnThe experts most familiar with defibrillation technology and assessment are often recipients of research support from manufacturers of automated external defibrillators (AEDs). Several of the authors and expert reviewers of this report have signed disclosure statements acknowledging training or research support from one or more AED manufacturers. However, in every case, support was administered through the academic institutions employing those individuals. No one has disclosed receiving personal salary support or consultant’s fees from any AED manufacturer, nor has anyone disclosed that they are or were a shareholder, paid advisor, or member of an advisory board of an AED manufacturer. The same is true of ECC Committee members with one exception, an employee of an AED manufacturer who abstained from discussions of the reviewed material and this statement.nnThe final statement was reviewed and approved by the AHA Science Advisory and Coordinating Committee, 2 ECC science advisors, and 2 AHA vice presidents. These reviewers were familiar with the comments and recommendations of the expert reviewers and their disclosure statements. It was the opinion of the final reviewers that statements by the writing group and reviewers were objective, balanced, and based on known scientific facts and did not appear influenced by the disclosed possible conflicts of interest.nnThis report addresses important clinical questions regarding newly developed AEDs that deliver impedance-compensating, fixed, low-energy …

Utstein-style guidelines for uniform reporting of laboratory CPR research

Both laboratory and clinical investigators contribute to the multidisciplinary knowledge base of resuscitation science. While diversity can be a strength, it can also be a hindrance because of the lack of a common language and poor communication among investigators. Modern cardiopulmonary resuscitation (CPR) research depends on the use of animal models that are designed to simulate cardiac arrest in humans [1,2]. Such models are used to explore important new treatments and to refine protocols used in standard interventions, including doses of drugs, chest compression techniques, defibrillation energies, and cerebral resuscitation, before they are applied to humans [3]. When favorable results are reported in animal models, the new or refined techniques are often implemented soon afterward in human victims of cardiac arrest. Unfortunately, the results obtained in one laboratory may not be reproducible in another laboratory or in human trials. For example, highdose epinephrine therapy significantly improves survival in most animal models of cardiac arrest but does not improve survival in humans [4–7]. In addition, some animal studies have documented the efficacy of administering bicarbonate during cardiac arrest, while others have shown it to be ineffective or deleterious [8]. Some of these differences are to be expected because an animal simulation is not a perfect model of cardiac arrest in humans. However, it is likely that some of these conflicting results are due to differences in experimental methods and laboratory model design. Variations in study design, such as the quality of chest compressions and ventilation, definitions of variables, or time intervals between an event and the beginning of therapy, are probably responsible for many of the inconsistencies and contradictions reported. The lack of standardization and the use of nonuniform terminology in reports of studies of cardiac arrest in humans have been described as a ‘Tower of Babel’ [9]. To address these problems, par‘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. This statement is also being published in Circulation and Annals of Emergency Medicine. Single requests for reprints are free: should be sent to the American Heart Association, Public Information, 7272 Greenville Avenue, Dallas, TX 75231-4596. Fax to Public Information, 214 369 3685.© 1996 American Heart Association, Inc.

Cardiac Arrest: Therapy of sudden death

Part I. Introduction Part II. Basic Science Part IV. The Pathophysiology of Global Ischemia and Reperfusion Part V. Perfusion Pressures Part VI. Therapy of Sudden Death Part VII. External Chest Compression Part VIII. Vasopressor Therapy During Cardiac Arrest Part IX. Postresuscitation Disease and its Care Part X. Special Resuscitation Circumstances Part XI. Special Issues in Resuscitation.

Cardiac Arrest: Basic science

Part I. Introduction Part II. Basic Science Part IV. The Pathophysiology of Global Ischemia and Reperfusion Part V. Perfusion Pressures Part VI. Therapy of Sudden Death Part VII. External Chest Compression Part VIII. Vasopressor Therapy During Cardiac Arrest Part IX. Postresuscitation Disease and its Care Part X. Special Resuscitation Circumstances Part XI. Special Issues in Resuscitation.

Cardiac Arrest: The pathophysiology of global ischemia and reperfusion

Part I. Introduction Part II. Basic Science Part IV. The Pathophysiology of Global Ischemia and Reperfusion Part V. Perfusion Pressures Part VI. Therapy of Sudden Death Part VII. External Chest Compression Part VIII. Vasopressor Therapy During Cardiac Arrest Part IX. Postresuscitation Disease and its Care Part X. Special Resuscitation Circumstances Part XI. Special Issues in Resuscitation.

Cardiac Arrest: Contents

Part I. Introduction Part II. Basic Science Part IV. The Pathophysiology of Global Ischemia and Reperfusion Part V. Perfusion Pressures Part VI. Therapy of Sudden Death Part VII. External Chest Compression Part VIII. Vasopressor Therapy During Cardiac Arrest Part IX. Postresuscitation Disease and its Care Part X. Special Resuscitation Circumstances Part XI. Special Issues in Resuscitation.

Cardiac Arrest: Special issues in resuscitation

Part I. Introduction Part II. Basic Science Part IV. The Pathophysiology of Global Ischemia and Reperfusion Part V. Perfusion Pressures Part VI. Therapy of Sudden Death Part VII. External Chest Compression Part VIII. Vasopressor Therapy During Cardiac Arrest Part IX. Postresuscitation Disease and its Care Part X. Special Resuscitation Circumstances Part XI. Special Issues in Resuscitation.

Cardiac Arrest: Postresuscitation disease and its care

Part I. Introduction Part II. Basic Science Part IV. The Pathophysiology of Global Ischemia and Reperfusion Part V. Perfusion Pressures Part VI. Therapy of Sudden Death Part VII. External Chest Compression Part VIII. Vasopressor Therapy During Cardiac Arrest Part IX. Postresuscitation Disease and its Care Part X. Special Resuscitation Circumstances Part XI. Special Issues in Resuscitation.

Cardiac Arrest: Introduction

Part I. Introduction Part II. Basic Science Part IV. The Pathophysiology of Global Ischemia and Reperfusion Part V. Perfusion Pressures Part VI. Therapy of Sudden Death Part VII. External Chest Compression Part VIII. Vasopressor Therapy During Cardiac Arrest Part IX. Postresuscitation Disease and its Care Part X. Special Resuscitation Circumstances Part XI. Special Issues in Resuscitation.

Cardiac Arrest: Index

Part I. Introduction Part II. Basic Science Part IV. The Pathophysiology of Global Ischemia and Reperfusion Part V. Perfusion Pressures Part VI. Therapy of Sudden Death Part VII. External Chest Compression Part VIII. Vasopressor Therapy During Cardiac Arrest Part IX. Postresuscitation Disease and its Care Part X. Special Resuscitation Circumstances Part XI. Special Issues in Resuscitation.