Until now, there has been no evidence that anesthetic drugs could have a positive impact on the heart, which has only just been restored. But after this study, however, this is not the case.
If a patient is successfully resuscitated after a cardiac arrest, they are not out of danger yet. Various factors can influence whether and how they survive this trauma.
This study was conducted by the Research Association for Emergency Medicine Ostwestfalen-Lippe led by the University Clinic for Anesthesiology, Intensive Care and Emergency Medicine at the Johannes Wesling Clinic in Minden, hospital of Ruhr University Bochum, Germany, at the Chair of Emergency Medicine headed by Professor Jochen Hinkelbein on 571 patients.
The study was published in the journal Deutsches Ärzteblatt International on April 8, 2024.
Patients who survived a cardiac arrest and were admitted to hospital, out of which 395 were sedated, 249 of them with midazolam. When midazolam was administered, the chance that their blood oxygen saturation levels came within optimal range following a cardiac arrest increased twice, and the chance that carbon dioxide was exhaled effectively increased by 1.6 times.
"Some patients display protective reflexes after resuscitation, such as coughing or defensive movements, which make the emergency responders' work more difficult. They often have to perform extended airway management, for example by intubating the patient in the same way as during surgery. This frequently requires sedation or anesthesia."
Dr. Gerrit Jansen, lead author of the study
When the patient required anesthesia after successful cardiopulmonary resuscitation (CPR), midazolam improved the chances of adequate oxygen saturation and CO2 levels in the patient's blood.
This specific group of patients who have been successfully resuscitated should definitely be included in the guidelines for pre-hospital anesthesia. Midazolam has proven to have a particularly positive effect on this group. Our statistical methods confirmed a correlation between these results and the administration of midazolam, without any indication of negative circulatory effects.
Dr. Gerrit Jansen
But sometimes the patient does not regain consciousness at that time. In this case, there are a lot of factors that can affect the chances of survival.
"The European guidelines of the European Resuscitation Council don't yet set out any specific recommendations for possible anesthetic drugs. The German guideline for pre-hospital anesthesia for patients with cardiovascular risk doesn't mention patients in cardiac arrest. We've therefore carried out pioneering research in this field, the results of which should be incorporated into the recommendations for the benefit of the patients."
Dr. Gerrit Jansen
(Input from various sources)
(Rehash/Dr. Pragati Priya/MSM)
