CBA2法—蘇生ガイドライン2015をもとに抗精神病薬による致死的不整脈の蘇生法を提案する

The CBA2 Method: Cardiopulmonary Resuscitation for Fatal Arrhythmia Caused by Antipsychotics

抄録

　抗精神病薬は致死的不整脈を惹起するリスクがある。蘇生ガイドライン2015をもとに，抗精神病薬による致死的不整脈の蘇生方法としてCBA²法を提唱した。CBA²は，胸骨圧迫（compression），人工呼吸（breathing），アドレナリン（adrenaline），自動体外式除細動器（automated external defibrillator；AED）の頭文字である。致死的不整脈に遭遇した時には，この順番で数分以内に蘇生を開始することが重要である。

　Sudden cardiac arrest remains a leading cause of death in psychiatric patients, because antipsychotic drugs are associated with an increased risk of ventricular arrhythmia. Thus, the provision of effective cardiopulmonary resuscitation (CPR) is additionally required for all health care providers in psychiatry. CPR for cardiac arrest patients taking antipsychotics may be performed without using adrenaline, because antipsychotics and adrenaline are contraindicated through the risk of adrenaline reversal. However, adrenaline produces beneficial effects in patients during cardiac arrest due to its pharmacological properties. I have developed a cardiopulmonary resuscitation method called “CBA²”, which is based on the 2015 International Consensus Meeting on cardiopulmonary resuscitation and emergency cardiovascular care. The acronym CBA² represents “compression”, “breathing”, “adrenaline”, and “automated external defibrillator (AED)”. To rescue cardiac arrest patients taking antipsychotics, the defibrillator along with early administration of adrenaline should be used as quickly as possible, with continuous chest compressions and appropriate ventilation.