| Title： | Chinese guidelines for diagnosis and treatment of post-cardiac arrest syndrome in adults by combining traditional Chinese and Western medicine |
| Edition： | Original |
| Classification： | Traditional Chinese Medicine guideline |
| Field： | Treatment |
| Countries and regions： | China |
| Guidelines users： | Doctors and nurses in emergency department, intensive care medicine department and other clinical departments, teachers and researchers engaged in diagnosis and treatment of adult post-cardiac arrest syndrome. |
| Evidence classification method： | GRADE |
| Development unit： | The Taskforce includes experts from the Emergency Medicine Professional Committee of the Chinese Society of Integrated Traditional and Western Medicine and experts from Tongde Hospital in Zhejiang Province |
| Registration time: | 2024-09-08 |
| Registration number： | PREPARE-2024CN437 |
| Purpose of the guideline: | Cardiac arrest (CA) is a serious clinical event in which the mechanical activity of the heart stops suddenly and the circulation signs disappear in an unexpected short time. Its high incidence rate and low survival rate are one of the major problems worldwide. Despite the continuous improvement of emergency medical service systems and emergency technology, the recovery rate of spontaneous circulation in the early stage of cardiac arrest has increased, but the survival rate after discharge is still very low. The treatment results of CA patients depend on the patient's primary disease, the witness's high-quality cardiopulmonary resuscitation (CPR) and every link of the resuscitation survival chain. During cardiac arrest, severe ischemia and hypoxia occur in the tissues and organs of the body, leading to the release of inflammatory factors and the production of various metabolites. After CPR and return of spontaneous circulation (ROSC), reperfusion injury occurs, leading to dysfunction or obstruction of multiple organs in the body, known as post-cardiac arrest syndrome (PCAS). At present, the treatment focus of western medicine for cardiac arrest is to reverse the pathological and physiological manifestations of PCAS, and timely and appropriate cluster management of PCAS. In recent years, domestic and foreign scholars have conducted a large amount of research on PCAS and published many high-quality studies, accumulating evidence for the diagnosis and treatment of PCAS. However, currently, the mortality rate of PCAS patients has not significantly decreased. There are still many urgent issues that need to be addressed in the relevant consensus opinions at home and abroad, and more high-quality clinical and basic research needs to be carried out to explore and evaluate. Traditional Chinese medicine has multiple targeted effects such as improving post resuscitation circulation, clearing oxygen free radicals, inhibiting inflammatory reactions, and regulating immunity. The combination of traditional Chinese and western medicine in the treatment of multiple pathways and targets, which complement each other's strengths and weaknesses, can better alleviate ischemia-reperfusion injury and thus improve multi-organ function. More and more studies have shown its clinical value. Although the combination of traditional Chinese and western medicine has a better effect on PCAS, it is found through document retrieval that the diagnosis and treatment standard in the field of traditional Chinese medicine is only the "Expert Consensus on the Clinical Diagnosis and Treatment of Sudden Death in Traditional Chinese Medicine (2020)". At present, in the field of traditional Chinese medicine and integrated Chinese and western medicine, there is no expert consensus on the diagnosis and treatment of PCAS at home and abroad, and standardized treatment plans have not been formed, and the evaluation criteria of efficacy are different, and it is more difficult to form a consensus in the promotion. There are many clinical problems, such as how to integrate the four diagnostic methods of Chinese medicine into the monitoring and comprehensive assessment of the disease in a timely and effective manner, how to combine disease differentiation and syndrome differentiation to formulate dialectical classification standards of integrated Chinese and western medicine, circulation management, respiratory support, prevention and treatment of central nervous system damage, elimination of reversible causes, treatment of epileptiform seizures, intervention in kidney failure, gastrointestinal protection, and other aspects of how to integrate traditional Chinese and western medicine treatment, are urgent to formulate norms. On the basis of long-term clinical practice, our working group proposed the clinical problems in the diagnosis and treatment of adult PCAS with integrated traditional Chinese and western medicine through the research on the diagnosis and treatment of adult PCAS with integrated traditional Chinese and western medicine. According to high-quality evidence-based evidence, and in combination with the opinions of the majority of Chinese first-aid experts in cardiopulmonary resuscitation with integrated traditional Chinese and western medicine, we compiled the first Chinese guidelines on the treatment of PCAS with integrated traditional Chinese and western medicine. The guidelines opinion can serve as a reference for the first aid workers of integrated Chinese and western medicine to carry out clinical diagnosis and treatment of PCAS, hoping to further improve the efficacy of PCAS, and has significant social significance and clinical value. |
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