Cardiology
Cardiopulmonary arrest & resuscitation
Cardiac arrest is a time-critical emergency that requires rapid, evidence-based interventions to improve survival rates and neurological outcomes. High-quality cardiopulmonary resuscitation (CPR), defibrillation, and post-resuscitation care are essential components of advanced life support (ALS).
This section covers:
- Updated advanced life support (ALS) guidelines, detailing best practices for in-hospital and out-of-hospital cardiac arrest management.
- Cardiac arrest in special circumstances, including adaptations for cases caused by hypoxia, trauma, anaphylaxis, sepsis, hypothermia, and electrolyte imbalances.
- Post-resuscitation care, focusing on hemodynamic optimization, neurological assessment, and targeted temperature management to enhance patient recovery.
By following evidence-based guidelines and resuscitation protocols, healthcare providers can ensure effective interventions, reduce complications, and optimize long-term outcomes for patients experiencing cardiac arrest.
Advanced life support guidelines
Adult Advanced Life Support
European Resuscitation Council Guidelines 2025 Adult Advanced Life Support
Jasmeet Soar et al., Resuscitation (2025)
What’s inside
The 2025 ERC Adult Advanced Life Support (ALS) guidelines provide evidence-based recommendations for the prevention, recognition, and treatment of in- and out-of-hospital cardiac arrest in adults. The guidelines emphasize early and effective ALS interventions, including defibrillation, airway management, medication, and post-resuscitation care, based on the latest ILCOR consensus and focused literature reviews.
Why it’s relevant
Cardiac arrest remains a leading cause of mortality, with survival rates often below 10% for out-of-hospital events. These guidelines are crucial for critical care professionals as they standardize ALS practices, integrate new evidence on defibrillation strategies, airway management, and drug administration, and address special circumstances such as CPR-induced consciousness and refractory arrhythmias.
Key focus
- Early initiation of ALS and high-quality chest compressions
- Optimal defibrillation strategies, including pad placement and energy levels
- Stepwise airway management and confirmation of correct tracheal tube placement
- Use of waveform capnography to guide CPR quality and ROSC detection
- Physiology-guided CPR and tailored drug regimens for shockable/non-shockable rhythms
Cardiac arrest in special circumstances
See elsewhere for CPR of the newborn, paediatric and pregnant.
Special Circumstances in Resuscitation
European Resuscitation Council Guidelines 2025 Special Circumstances in Resuscitation
Carsten Lott et al., Resuscitation (2025)
What’s inside
The ERC Guidelines 2025 provide evidence-based recommendations for managing cardiac arrest in special circumstances, including unique causes, settings, and patient populations. The guidelines emphasize tailored approaches for laypeople and healthcare professionals, addressing modifications to basic and advanced life support protocols.
Why it’s relevant
Cardiac arrest management must adapt to specific contexts, such as anaphylaxis, electrolyte disorders, hypothermia, and trauma. These guidelines standardize approaches to improve outcomes, reduce morbidity, and ensure timely, effective interventions across diverse scenarios.
Key focus
- Risk stratification and rapid intervention for anaphylaxis and hyperkalaemia
- Specialized algorithms for hypothermia, drowning, and traumatic cardiac arrest
- Modified resuscitation protocols for pregnant patients and unique settings (e.g., catheterization lab)
- Emphasis on reversible causes and early use of advanced interventions like ECPR
Post-resuscitation care & prognostication
Post-resuscitation care guidelines
European Resuscitation Council and European Society of Intensive Care Medicine Guidelines 2025 Post-Resuscitation Care
Jerry P. Nolan et al., Resuscitation (2025)
What’s inside
The 2025 ERC-ESICM guidelines provide evidence-based recommendations for post-resuscitation care, focusing on adults after cardiac arrest. Key topics include airway and oxygenation management, coronary reperfusion, haemodynamic targets, temperature control, seizure management, prognostication, rehabilitation, and organ donation.
Why it’s relevant
Post-resuscitation care is critical for improving survival and neurological outcomes after cardiac arrest. These guidelines standardize approaches to optimize patient recovery, reduce complications, and support long-term rehabilitation, ensuring consistent, high-quality care across diverse clinical settings.
Key focus
- Immediate coronary angiography for ST elevation or suspected coronary occlusion
- Targeted oxygenation (SpO₂ 94–98%) and normocapnia (PaCO₂ 35–45 mmHg)
- Haemodynamic management targeting MAP >60–65 mmHg
- Active fever prevention (temperature ≤37.5°C) for comatose patients
- Multimodal prognostication using clinical, neurophysiological, and imaging assessments