2022 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces

Abstract

This is the sixth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. This summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. Topics covered by systematic reviews include cardiopulmonary resuscitation during transport; approach to resuscitation after drowning; passive ventilation; minimizing pauses during cardiopulmonary resuscitation; temperature management after cardiac arrest; use of diagnostic point-of-care ultrasound during cardiac arrest; use of vasopressin and corticosteroids during cardiac arrest; coronary angiography after cardiac arrest; public-access defibrillation devices for children; pediatric early warning systems; maintaining normal temperature immediately after birth; suctioning of amniotic fluid at birth; tactile stimulation for resuscitation immediately after birth; use of continuous positive airway pressure for respiratory distress at term birth; respiratory and heart rate monitoring in the delivery room; supraglottic airway use in neonates; prearrest prediction of in-hospital cardiac arrest mortality; basic life support training for likely rescuers of high-risk populations; effect of resuscitation team training; blended learning for life support training; training and recertification for resuscitation instructors; and recovery position for maintenance of breathing and prevention of cardiac arrest. Members from 6 task forces have assessed, discussed, and debated the quality of the evidence using Grading of Recommendations Assessment, Development, and Evaluation criteria and generated consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections, and priority knowledge gaps for future research are listed.

One-Year Review in Cardiac Arrest: The 2022 Randomized Controlled Trials

“…Thus, this study does not support the need to modify current recommendations by reintroducing vasopressin as an alternative drug for CPR. However, there are other studies that have shown benefits from a combination of vasopressin with corticosteroids for IHCA on a short-term outcome, but with more uncertainty regarding survival and neurological recovery [ 23 , 24 , 25 ].…”

Cardiac arrest, stony heart, and cardiopulmonary resuscitation: An updated revisit

“…During cardiac arrest, CBF is already losing 60% during chest compression only, and it needs at least 3 min of ROSC to be normalized[ 48 ]. The current Western guidelines do not recommend using Vasopressin and glucocorticoids in IHCA and OHCA[ 45 , 49 ]. However, few studies attributed the improvement of PAMD and peri-arrest cerebral ischemia to the impact of Vasopressin on the early improved post-arrest mean arterial pressure and central venous oxygen saturation, the use of less dosages of epinephrine, the shorter duration of CPR, and the use of methylprednisolone during resuscitation[ 36 , 44 , 50 ].…”

“…Nevertheless, after rewarming, a more extended period of vasopressor support is still needed in patients with OHCA[ 77 ]. The 2022 International Consensus on Cardiopulmonary Resuscitation recommended not to routinely use pre-hospital cooling with a rapid infusion of large volumes of cold intravenous fluid immediately after ROSC and suggested active fever prevention for at least 72 h for patients who remain comatose after ROSC[ 49 ]. Also, patients who remained in a coma and had mild hypothermia after ROSC should not be actively rewarmed to attain normal body temperature[ 49 ].…”

Ultrasound during Advanced Life Support—Help or Harm?

“…They recommend, either implicitly or explicitly, its use during CPR. However, many guidelines by major national and international resuscitation societies are either equivocal or warn against the general use of ultrasound in ALS [ 7 , 8 , 9 , 10 ]. These guidelines cite lack of evidence of effectiveness and potential harm from performing ultrasound during ALS resuscitation.…”