Notfallbausteine

Pulslose elektrische Aktivität (PEA)

Zuletzt geändert:

  • Simplifizierter Algorithmus1
    • QRS schmal = mechanisch / RV Problem: POCUS LV hyperdynam, Pseudo-PEA (Tamponade, Spannungspneumothorax, LAE, OMI)
    • QRS breit = metabolisch / LV Problem: POCUS LV akinetisch, “echte” PEA (HyperK+, Natriumkanalblocker, OMI)
  • QRS <120ms und HF >60 beneficial2
  • Outcome PEA besser als ASY (OR+ 2.1, OHCA sogar OR+ 4.2)3
  • Pseudo-PEA mit Vasopressoren behandeln ist besser als drauf rumdrücken4

Footnotes

  1. Laszlo Littmann, Devin J. Bustin, Michael W. Haley; A Simplified and Structured Teaching Tool for the Evaluation and Management of Pulseless Electrical Activity. Med Princ Pract 1 December 2013; 23 (1): 1–6. https://doi.org/10.1159/000354195 ↩

  2. Kim, J. H., Lee, J., Shin, H., Lim, T. H., Jang, B. H., Cho, Y., … Kwon, S. M. (2024). Association Between QRS Characteristics in Pulseless Electrical Activity and Survival Outcome in Cardiac Arrest Patients: A Systematic Review and Meta-Analysis. Prehospital Emergency Care, 29(2), 162–169. https://doi.org/10.1080/10903127.2024.2360139 ↩

  3. Contextualizing Pseudo-Pulseless Electrical Activity in Cardiac Arrest: A Meta-Analysis and Systematic Review ↩

  4. Gregor Prosen. J Int Med Res 2010. Impact of modified treatment in echocardiographically confirmed pseudo-pulseless electrical activity in out-of-hospital cardiac arrest patients with constant end-tidal carbon dioxide pressure during compression pauses ↩

Graphansicht