Hemodynamic-directed cardiopulmonary resuscitation during in-hospital cardiac arrest.
Cardiopulmonary resuscitation (CPR) guidelines assume that cardiac arrest victims can be treated with a uniform chest compression (CC) depth and a standardized interval administration of vasopressor drugs. This non-personalized approach does not incorporate a patient's individualized response into ongoing resuscitative efforts. In previously reported porcine models of hypoxic and normoxic ventricular fibrillation (VF), a hemodynamic-directed resuscitation improved short-term survival compared to current practice guidelines. Skilled in-hospital rescuers should be trained to tailor resuscitation efforts to the individual patient's physiology. Such a strategy would be a major paradigm shift in the treatment of in-hospital cardiac arrest victims.
The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Department of Anesthesiology and Critical Care Medicine, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, United States.
Robert M
RM
Sutton
St. Louis Children's Hospital, Washington University in St. Louis School of Medicine, Department of Pediatrics, 660 South Euclid Avenue, St. Louis, MO 63110, United States.
Stuart H
SH
Friess
The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Department of Anesthesiology and Critical Care Medicine, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, United States.
Matthew R
MR
Maltese
The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Department of Anesthesiology and Critical Care Medicine, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, United States.
Maryam Y
MY
Naim
The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Department of Anesthesiology and Critical Care Medicine, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, United States.
George
G
Bratinov
The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Department of Anesthesiology and Critical Care Medicine, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, United States.
Theodore R
TR
Weiland
The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Department of Anesthesiology and Critical Care Medicine, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, United States.
Mia
M
Garuccio
Bloomberg Children's Center, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Department of Anesthesiology and Critical Care Medicine, 1800 Orleans Street, Baltimore, MD 21287, United States.
Utpal
U
Bhalala
The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Department of Anesthesiology and Critical Care Medicine, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, United States.
Vinay M
VM
Nadkarni
The Hospital of the University of Pennsylvania, University of Pennsylvania Perelman School of Medicine, Department of Emergency Medicine, 3400 Spruce Street, Philadelphia, PA 19104, United States.
Lance B
LB
Becker
The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Department of Anesthesiology and Critical Care Medicine, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, United States. Electronic address: suttonr@email.chop.edu.
Robert A
RA
Berg
D000818:Animals; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D006323:Heart Arrest / Q000503:physiopathology / Q000628:therapy*; D006439:Hemodynamics; D006801:Humans
Arterial blood pressure; Cardiac arrest; Cardiopulmonary resuscitation