title: Anesthesia advanced circulatory life support.
abstract: OBJECTIVE
  The constellation of advanced cardiac life support (ACLS) events, such as gas embolism, local anesthetic overdose, and spinal bradycardia, in the perioperative setting differs from events in the pre-hospital arena. As a result, modification of traditional ACLS protocols allows for more specific etiology-based resuscitation.
  
  
  RESULTS
  Perioperative arrests are both uncommon and heterogeneous and have not been described or studied to the same extent as cardiac arrest in the community. These crises are usually witnessed, frequently anticipated, and involve a rescuer physician with knowledge of the patient's comorbidities and coexisting anesthetic or surgically related pathophysiology. When the health care provider identifies the probable cause of arrest, the practitioner has the ability to initiate medical management rapidly.
  
  
  CONCLUSIONS
  Recommendations for management must be predicated on expert opinion and physiological understanding rather than on the standards currently being used in the generation of ACLS protocols in the community. Adapting ACLS algorithms and considering the differential diagnoses of these perioperative events may prevent cardiac arrest.
authors.affiliation: Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
authors.forename: Vivek K
authors.initials: VK
authors.lastname: Moitra
authors.forename: Andrea
authors.initials: A
authors.lastname: Gabrielli
authors.forename: Gerald A
authors.initials: GA
authors.lastname: Maccioli
authors.forename: Michael F
authors.initials: MF
authors.lastname: O'Connor
mesh_terms: D022561:Advanced Cardiac Life Support / Q000379:methods*; D000465:Algorithms; D000758:Anesthesia / Q000009:adverse effects / Q000379:methods; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D003937:Diagnosis, Differential; D006323:Heart Arrest / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control*; D013997:Time Factors