Even if a patient is revived after a cardiac arrest and circulation is restored, their survival is still uncertain. Many factors can determine whether and how they recover from the ordeal. A multicenter study involving 571 patients found that the use of the anaesthetic midazolam has a beneficial effect.Midazolam has been found to have a positive effect, according to a study of 571 patients 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, hospital of Ruhr University Bochum, Germany, at the Chair of Emergency Medicine headed by Professor Jochen Hinkelbein.
When patients required anesthesia after successful resuscitation, midazolam improved the chances of optimal oxygen saturation and CO2 levels in the blood. The risk of a renewed drop in blood pre rnrnThe study published in the journal Deutsches Ärzteblatt International on April 8, 2024, concluded that patients who have been successfully resuscitated should be included in pre-hospital anesthesia guidelines. Dr. Gerrit Jansen, the lead author, stated that midazolam has shown to have a particularly positive effect in this group. Rapid intervention is crucial in the event of a cardiac arrest, as timely resuscitation measures by first aiders can potentially restart the patient’s circulation. However, the study found that the use of midazolam did not increase the risk of increased intracranial pressure or renewed circulatory arrest in these patients.Gerrit Jansen explains that it is common for the patient to still be unconscious at this stage. There are many factors that can impact the chances of survival and any long-term limitations after the circulatory arrest. Jansen says, “Some patients have protective reflexes after being resuscitated, like coughing or defensive movements, which can make it harder for emergency responders. They often need to manage the patient’s airway for an extended period, which may involve intubation similar to what is done during surgery. This often requires sedation or anesthesia.” Previously, there were concerns thatAnaesthetic drugs may have a negative impact on the circulatory system, especially right after it has been restored. However, a recent study has shown that this may not be the case.
Out of the 571 individuals who were part of the study and survived a cardiac arrest and were hospitalized, 395 were given sedatives, with 249 of them receiving midazolam. The likelihood of their blood oxygen saturation levels being in the optimal range after a cardiac arrest doubled when midazolam was administered. Additionally, the likelihood of effectively exhaling carbon dioxide increased by 1.6 times with the use of the drug. “Our statistical analysis confirmed a connection between these findings and the use of midazolam,” the researchers stated.Gerrit Jansen stated, “the use of midazolam, with no indication of negative effects on circulation.” He also pointed out that “European Resuscitation Council guidelines do not currently provide specific recommendations for potential anesthetic medications.” Additionally, he mentioned that the German guideline for pre-hospital anesthesia for patients with cardiovascular risk does not address patients in cardiac arrest. Jansen emphasized the importance of incorporating the results of their research into recommendations for the benefit of patients.
