Læknablaðið - 15.11.2006, Blaðsíða 42

FRÆÐIGREINAR / KLÍNÍSKAR
LEIÐBEININGAR / ENDURLIFGUN
ing hafi verndandi áhrif á þau eins og á fullorðið
fólk. Því kemur sterklega til greina að kæla börn
eftir hjartastopp samkvæmt þeim vinnureglum
sem notaðar eru við kælingu á fullorðnum (7).
Slíkar vinnureglur hafa verið notaðar um skeið á
gjörgæsludeildum Landspítala (35).
Lokaorð
Við endurlífgun skipta skjót og rétt handtök einna
mestu máli um hvernig til tekst. Því er nauðsynlegt
að heilbrigðisstarfsfólk sé vel að sér um grundvall-
aratriði endurlífgunar og að öll skipulagning á
viðbrögðum við bráðatilfellum á sjúkrastofnunum
sé eins og best verður á kosið. Regluleg þjálfun á
þessu sviði er nauðsynleg ef svo á að vera.
í þessari grein eru gefnar leiðbeiningar um end-
urlífgun á börnum sem einkum eru ætlaðar heil-
brigðisstarfsfólki. Þær byggjast á alþjóðlegum end-
urlífgunarleiðbeiningum sem nýlega hafa verið
endurskoðaðar. Er það von höfunda að þær auki
skilning á sérstöðu barna á þessu sviði og verði
gagnlegt innlegg við þjálfun heilbrigðisstarfsfólks
í endurlífgun á börnum hér á landi.
Heimildir
1. Herlitz J, Engdahl J, Svensson L, Young M, Angquist KA,
Holmberg S. Characteristics and outcome among children
suffering from out of hospital cardiac arrest in Sweden.
Resuscitation 2005; 64:37-40.
2. Young KD, Gausche-Hill M, McClung CD, Lewis RJ. A
prospective, population-based study of the epidemiology and
outcome of out-of-hospital pediatric cardiopulmonary arrest.
Pediatrics 2004; 114:157-64.
3. Samson RA, Nadkarni VM, Meaney PA, Cary SM, Berg MD,
Berg RA. Outcomes of in-hospital ventricular fibrillation in
children. N Engl J Med 2006; 354:2328-39.
4. Kuisma M, Suominen P, Korpela R. Paediatric out-of-hospital
cardiac arrests-epidemiology and outcome. Resuscitation
1995;30:141-50.
5. Leiöbeiningar um grunnendurlífgun. Skyndihjálparráð íslands
2006. www.landlaeknir.is
6. International Liaison Committee on Resuscitation. Paediatric
basic and advanced life support. Resuscitation 2005; 67: 271-
91.
7. Biarent D, Bingham R, Richmond S, Maconochie I, Wyllie J,
Simpson S, et al. European resuscitation council guidelines
for resuscitation 2005: Section 6. Paediatric life support.
Resuscitation 2005; 67: S97-S133.
8. American Heart Association. Pediatric basic and advanced life
support. Circulation 2005; 112: III-73-III-90.
9. American Heart Association. Pediatric basic life support.
Circulation 2005; 112 Suppl: IV-156-IV-66.
10. American Heart Association. Pediatric advanced life support.
Circulation 2005; 112 Suppl: IV-167-IV-87.
11. Kuisma M, Suominen P, Korpela R. Paediatric out-of-hospital
cardiac arrests - epidemiology and outcome. Resuscitation
1995; 30:141-50.
12. Young KD, Seidel JS. Pediatric cardiopulmonary resuscitation:
a collective review. Ann Emerg Med 1999; 33:195-205.
13. Nadkarni VM. First Documented Rhythm and Clinical
Outcome From In-Hospital Cardiac Arrest Among Children
and Adults. JAMA 2006; 295:50-7.
14. Lopez-Herce J, Garcia C, Dominguez P, Carrillo A, Rodriguez-
Nunez A, Calvo C, et al. Characteristics and outcome of
cardiorespiratory arrest in children. Resuscitation 2004; 63:
311-20.
15. Wren C. Sudden death in children and adolescents. Heart 2002;
88:426-31.
16. Larsen MP, Eisenberg MS, Cummins RO, Hallstrom AP.
Predicting survival from out-of-hospital cardiac arrest: a
graphic model. Ann Emerg Medl993; 22:1652-8.
17. Khine HH, Corddry DH, Kettrick RG, Martin TM,
McCloskey JJ, Rose JB, et al. Comparison of cuffed and
uncuffed endotracheal tubes in young children during general
anesthesia. Anesthesiology 1997; 86:627-31.
18. Houri PK, Frank LR, Menegazzi JJ, Taylor R. A randomized,
controlled trial of two-thumb vs two-finger chest compression
in a swine infant model of cardiac arrest. Prehospital Emerg
Care 1997; 1:65-7.
19. Menegazzi JJ, Auble TE, Nicklas KA, Hosack GM, Rack L,
Goode JS. Two-thumb versus two-finger chest compression
during CRP in a swine infant model of cardiac arrest. Ann
Emerg Med 1993; 22:240-3.
20. Kissoon N, Idris A, Wenzel V, Murphy S, Rush W. Intraosseous
and central venous blood acid-base relationship during
cardiopulmonary resuscitation. Pediatric Emerg Care 1997; 13:
250-3.
21. Brickman KR, Krupp K, Rega P, Alexander J, Guinness M.
Typing and screening of blood from intraosseous access. Ann
Emerg Med 1992;21:414-7.
22. Johnson L, Kissoon N, Fiallos M, Abdelmoneim T, Murphy
S. Use of intraosseous blood to assess blood chemistries and
hemoglobin during cardiopulmonary resuscitation with drug
infusions. Crit Care Med 1999; 27:1147-52.
23. Rosetti VA,Thompson BM, Miller J, Mateer JR, Aprahamian
C. Intraosseous infusion: an alternative route of pediatric
intravascular access. Ann Emerg Med 1985; 14:885-8.
24. Otto CW, Yakaitis RW, Blitt CD. Mechanism of action of
epinephrine in resuscitation from asphyxial arrest. Crit Care
Med 1981; 9:321-4.
25. Mann K, Berg RA, Nadkarni V. Beneficial effects of
vasopressin in prolonged pediatric cardiac arrest: a case series.
Resuscitation 2002; 52:149-56.
26. Bar-Joseph G,Abramson NS, Kelsey SF, MashiachT, Craig MT,
Safar P, et al. Improved resuscitation outcome in emergency
medical systems with increased usage of sodium bicarbonate
during cardiopulmonary resuscitation. Acta Anaesthesiol
Scand 2005; 49:6-15.
27. Stueven HA, Thompson B, Aprahamian C, Tonsfeldt DJ,
Kastenson EH. Lack of effectiveness of calcium chloride in
refractory asystole. Ann Emerg Med 1985; 14:630-2.
28. Katz AM, Reuter H. Cellular calcium and cardiac cell death.
Am J Cardiol 1979; 44:188-90.
29. Carcillo JA, Fields AI, American College of Critical Care
Medicine Task Force Committee M. Clinical practice
parameters for hemodynamic support of pediatric and
neonatal patients in septic shock. Crit Care Med 2002; 30:
1365-78.
30. Hale DE, Hypoglycemia, in Textbook of Pediatric Emergency
Medicine, Fleisher GR LS, Editor. Williams and Wilkins,
Baltimore 1993:944-6.
31. Atkins DL, Kenney MA. Automated external defibrillators:
safety and efficacy in children and adolescents. Pediatric Clin
NAm 2004; 51:1443-62.
32. Parwani V, Hsu B, Hoffman RJ. Experienced emergency
physicians cannot safely or accurately inflate endotracheal
tube cuffs or estimate endotracheal tube cuff pressure using
standard technique. Acad Emerg Med 2004; 11:490-1.
33. Hypothermia after Cardiac Arrest Study Group. Mild
therapeutic hypothermia to improve the neurologic outcome
after cardiac arrest. N Engl J Med 2002; 346:549-56.
34. Shankaran S, Laptook AR, Ehrenkranz RA, Tyson JE,
McDonald SA, Donovan EF, et al. Whole-body hypothermia
for neonates with hypoxic-ischemic encephalopathy. N Engl J
Med 2005; 353:1574-84.
35. ValssonF.Kælingmeðvitundarlausrasjúklingaeftirendurlífgun;
ný meðferð á íslandi. Læknablaðið 2004; 90:603-4.
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