A study conducted by the Research Association for Emergency Medicine Ostwestfalen-Lippe led by the University Clinic for Anaesthesiology, Intensive Care and Emergency Medicine at the Johannes Wesling clinic in Minden, Germany, has shown that the administration of the anaesthetic midazolam has a positive effect on patients who have been successfully resuscitated after a cardiac arrest. In a study of 571 patients, midazolam improved the chances of optimal oxygen saturation and CO2 levels in the blood without increasing the risk of a drop in blood pressure or circulatory arrest. This highlights the importance of including these specific patients in guidelines for pre-hospital anesthesia.
After a cardiac arrest, rapid intervention is crucial for restarting the patient’s circulation. However, many patients may not regain consciousness immediately, which can complicate the work of emergency responders. Some patients may exhibit protective reflexes that require extended airway management, such as intubation, which often necessitates sedation or anesthesia. Previously, there were concerns about the potential negative effects of anesthesia on the circulatory system, but the study found that midazolam did not have any adverse effects on patients who had just been resuscitated.
Of the 571 patients included in the study who survived a cardiac arrest and were admitted to the hospital, 395 were sedated, with 249 of them receiving midazolam. The administration of midazolam was associated with a twofold increase in the chance of optimal blood oxygen saturation levels and a 1.6-fold increase in the chance of effectively exhaling carbon dioxide. These results highlight the positive impact of midazolam on post-resuscitation care and suggest that it should be considered in guidelines for patients with cardiovascular risk who require pre-hospital anesthesia.
The European guidelines of the European Resuscitation Council do not currently provide specific recommendations for anesthetic drugs for patients in cardiac arrest, and the German guideline for pre-hospital anesthesia for patients with cardiovascular risk does not mention patients in cardiac arrest. Therefore, the study’s findings represent pioneering research in this area and should be incorporated into recommendations to benefit patients who have experienced a cardiac arrest. By including these findings in guidelines, healthcare providers can improve the care and outcomes for patients who have been successfully resuscitated.
In conclusion, the study demonstrates the positive effects of midazolam on patients who have been successfully resuscitated after a cardiac arrest. By improving oxygen saturation and CO2 levels without negatively impacting blood pressure or causing circulatory arrest, midazolam can play a crucial role in post-resuscitation care. This research highlights the importance of considering anesthetic drugs in the management of patients with cardiovascular risk who require pre-hospital anesthesia, and the need for updated guidelines to reflect these findings for the benefit of patients.
