Investigadores do Arizona verificaram recentemente que é possível aumentar o risco de sobrevivência, numa situação de paragem cardíaca, se um novo algoritmo de SAV pré-hospitalar for adoptado.
Num estudo publicado no Journal of the American Medical Association, ao aplicar 200 compressões torácicas antes da desfibrilhação, numa situação de paragem cardíaca, permite aumentar significativamente o fluxo sanguíneo cerebral, triplicando a taxa de sobrevivência em pessoas afectadas:
- Intervention Instruction: for EMS personnel in MICR (minimally interrupted cardiac resuscitation), an approach that includes an initial series of 200 uninterrupted chest compressions, rhythm analysis with a single shock, 200 immediate postshock chest compressions before pulse check or rhythm reanalysis, early administration of epinephrine, and delayed endotracheal intubation.
- Main Outcome Measure: Survival-to-hospital discharge.
- Results: Among the 886 patients in the 2 metropolitan cities, survival-to-hospital discharge increased from 1.8% (4/218) before MICR training to 5.4% (36/668) after MICR training (odds ratio [OR], 3.0; 95% confidence interval [CI], 1.1-8.9). In the subgroup of 174 patients with witnessed cardiac arrest and ventricular fibrillation, survival increased from 4.7% (2/43) before MICR training to 17.6% (23/131) after MICR training (OR, 8.6; 95% CI, 1.8-42.0). In the analysis of MICR protocol compliance involving 2460 patients with cardiac arrest, survival was significantly better among patients who received MICR than those who did not (9.1% [60/661] vs 3.8% [69/1799]; OR, 2.7; 95% CI, 1.9-4.1), as well as patients with witnessed ventricular fibrillation (28.4% [40/141] vs 11.9% [46/387]; OR, 3.4; 95% CI, 2.0-5.8).
- Conclusions: Survival-to-hospital discharge of patients with out-of-hospital cardiac arrest increased after implementation of MICR as an alternate EMS protocol. These results need to be confirmed in a randomized trial.