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Can J Anaesth. 2012 Jun;59(6):586-603. doi: 10.1007/s12630-012-9699-3. Epub 2012 Apr 21.

Anesthesia advanced circulatory life support.

Author information

  • 1Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.

Abstract

PURPOSE:

The constellation of advanced cardiac life support (ACLS) events, such as gas embolism, local anesthetic overdose, and spinal bradycardia, in the perioperative setting differs from events in the pre-hospital arena. As a result, modification of traditional ACLS protocols allows for more specific etiology-based resuscitation.

PRINCIPAL FINDINGS:

Perioperative arrests are both uncommon and heterogeneous and have not been described or studied to the same extent as cardiac arrest in the community. These crises are usually witnessed, frequently anticipated, and involve a rescuer physician with knowledge of the patient's comorbidities and coexisting anesthetic or surgically related pathophysiology. When the health care provider identifies the probable cause of arrest, the practitioner has the ability to initiate medical management rapidly.

CONCLUSIONS:

Recommendations for management must be predicated on expert opinion and physiological understanding rather than on the standards currently being used in the generation of ACLS protocols in the community. Adapting ACLS algorithms and considering the differential diagnoses of these perioperative events may prevent cardiac arrest.

PMID:
22528163
PMCID:
PMC3345112
DOI:
10.1007/s12630-012-9699-3
[PubMed - indexed for MEDLINE]
Free PMC Article
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