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The present and future of cardiac arrest care: international experts reach out to caregivers and healthcare authorities

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Abstract

Purpose

The purpose of this review is to describe the epidemiology of out-of-hospital cardiac arrest (OHCA), disparities in organisation and outcome, recent advances in treatment and ongoing controversies. We also outline the standard of care that should be provided by the critical care specialist and propose future directions for cardiac arrest research.

Methods

Narrative review with contributions from international resuscitation experts.

Results

Although it is recognised that survival rates from OHCA are increasing there is considerable scope for improvement and many countries have implemented national strategies in an attempt to achieve this goal. More resources are required to enable high-quality randomised trials in resuscitation.

Conclusions

Increasing international collaboration should facilitate resuscitation research and knowledge translation. The International Liaison Committee on Resuscitation (ILCOR) has adopted a continuous evidence review process, which facilitate the implementation of resuscitation interventions proven to improve patient outcomes.

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Authors and Affiliations

  1. Bristol Medical School, University of Bristol, Bristol, UK

    Jerry P. Nolan

  2. Anaesthesia and Intensive Care Medicine, Royal United Hospital, Bath, UK

    Jerry P. Nolan

  3. Pediatric Critical Care Medicine, Russell Raphaely Endowed Chair of Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, USA

    Robert A. Berg

  4. Anesthesiology and Critical Care Medicine, The University of Pennsylvania Perelman School of Medicine, Philadelphia, USA

    Robert A. Berg

  5. Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Clifton W. Callaway

  6. Rescu, St.Michael’s Hospital, 30 Bond St, Toronto, ON, M5B 1W8, Canada

    Laurie J. Morrison

  7. Department of Anesthesia and Critical Care Medicine, The Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA

    Vinay Nadkarni

  8. Warwick Medical School and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK

    Gavin D. Perkins

  9. Istituto Anestesiologia E Rianimazione, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario “Agostino Gemelli”, Largo Francesco Vito, 1, 00168, Rome, Italy

    Claudio Sandroni

  10. Division of Intensive Care, Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital and University of Helsinki, Haartmaninkatu 4, 00029 HUS, Helsinki, Finland

    Markus B. Skrifvars

  11. Intensive Care Medicine, Southmead Hospital, North Bristol NHS Trust, Bristol, BS10 5NB, UK

    Jasmeet Soar

  12. Department of Anaesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway

    Kjetil Sunde

  13. Medical ICU, Cochin Hospital (AP-HP), Paris-Cardiovascular-Research-Centre, INSERM U970 (Sudden Death Expertize Centre), Paris, France

    Alain Cariou

  14. Université Paris-Descartes-Sorbonne-Paris-Cité, Paris, France

    Alain Cariou

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  1. Jerry P. Nolan
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  2. Robert A. Berg
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Correspondence to Jerry P. Nolan.

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Conflicts of interest

JPN: Editor-in-Chief, Resuscitation; funding from the National Institute for Health Research to evaluate interventions in cardiac arrest including airway management (AIRWAYS-2 Study) and adrenaline (PARAMEDIC-2 Study). RAB: None declared. CC: None declared. LJM: None declared. VN: None declared. GDP: Funding from the National Institute for Health Research to evaluate interventions in cardiac arrest including mechanical CPR and adrenaline (PARAMEDIC-2 Study). CS: None declared. MS: Research grant from GE Healthcare, travel reimbursements and lecture fees from COVIDIEN, Astellas Pharma, Axis-Shield and BARD. JS: Editor, Resuscitation. KS: None declared. AC: Speakers fees and travel grants from Bard Medical.

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Nolan, J.P., Berg, R.A., Callaway, C.W. et al. The present and future of cardiac arrest care: international experts reach out to caregivers and healthcare authorities. Intensive Care Med 44, 823–832 (2018). https://doi.org/10.1007/s00134-018-5230-9

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  • DOI: https://doi.org/10.1007/s00134-018-5230-9

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