Physiology-directed cardiopulmonary resuscitation: Advances in precision monitoring during cardiac arrest

Alexandra M. Marquez, Ryan W. Morgan, Catherine E. Ross, Robert A. Berg, Robert M. Sutton

Research output: Contribution to journalReview articlepeer-review

12 Scopus citations

Abstract

Purpose of review We review the recent advances in physiologic monitoring during cardiac arrest and offer an evidence-based framework for prioritizing physiologic targets during cardiopulmonary resuscitation (CPR). Recent findings Current CPR guidelines recommend a uniform approach for all patients in cardiac arrest, but newer data support a precision strategy that uses the individual patient's physiology to guide resuscitation. Coronary perfusion pressure and arterial DBP are associated with survival outcomes in recent animal and human studies. End-tidal carbon dioxide is a reasonable noninvasive alternative, but may be inferior to invasive hemodynamic endpoints. Cerebral oximetry and cardiac ultrasound are emerging physiologic indicators of CPR effectiveness. Summary Physiologic monitoring can and should be used to deliver precision CPR whenever possible and may improve outcomes after cardiac arrest.

Original languageEnglish (US)
Pages (from-to)143-150
Number of pages8
JournalCurrent opinion in critical care
Volume24
Issue number3
DOIs
StatePublished - Jun 1 2018
Externally publishedYes

Bibliographical note

Funding Information:
Dr R.M.S. is primary investigator on a National Heart, Lung, and Blood Institute RO1 (HL131544) investigating hemodynamic-directed point-of-care CPR training and postcardiac arrest debriefings. Dr R.A.B. is a coinvestigator on Dr R.M.S. RO1.

Publisher Copyright:
© Copyright 2018 Wolters Kluwer Health, Inc. All rights reserved.

Keywords

  • cardiopulmonary resuscitation
  • coronary perfusion pressure
  • DBP
  • end-tidal carbon dioxide
  • physiologic monitoring

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