Search

Herzinsuffizienz ist vereinfacht definiert die Unfahigkeit des Herzens, die Korperperipherie mit einem ausreichenden Herzzeitvolumen zu versorgen. Dieses erniedrigte Herzzeitvolumen impliziert nach klassischer Betrachtungsweise eine Veranderung der Virchow-Trias, die Veranderungen des Blutflusses, der Endothelbeschaffenheit und der Blutzusammensetzung zusammenfasst und als pradisponierend fur thrombotische Erkrankungen beschreibt. Typische Veranderungen der Thrombogenese bei Herzinsuffizienz sind in Abb.1 summiert.

Cardiopulmonary resuscitation (CPR) is associated with a poor prognosis. Recent data suggest that chest compressions, even when performed by qualified persons, are often suboptimal. In clinical and laboratory studies, continuous chest compression can improve coronary perfusion pressures as a prerequisite for the restoration of circulation as compared with conventional CPR with chest compressions and ventilations. Results from animal studies clearly show that continuous chest compression performed by devices can improve the outcome after CPR compared to manual compressions. Currently, two devices for CPR are commercially available, LUCAS and AutoPulse. Few clinical studies have been performed with these devices, showing a trend towards a better restoration of spontaneous circulation. The effect of device-assisted CPR on long-term survival or neurologic status has not been addressed yet. Data are inconsistent, and the broad use of these devices currently can not be recommended on the basis of evidence. They may, however, be useful in selected patients, especially when the basic condition leading to CPR is likely to be reversed during prolonged measures, such as hyperkalemia or pulmonary embolism. The article summarizes currently available clinical data and the author’s experiences with the devices.