Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2014 Aug;85(8):983-6.
doi: 10.1016/j.resuscitation.2014.04.015. Epub 2014 Apr 28.

Hemodynamic-directed cardiopulmonary resuscitation during in-hospital cardiac arrest

Robert M Sutton  1 , Stuart H Friess  2 , Matthew R Maltese  1 , Maryam Y Naim  1 , George Bratinov  1 , Theodore R Weiland  1 , Mia Garuccio  1 , Utpal Bhalala  3 , Vinay M Nadkarni  1 , Lance B Becker  4 , Robert A Berg  5
Affiliations
Review

Hemodynamic-directed cardiopulmonary resuscitation during in-hospital cardiac arrest

Robert M Sutton et al. Resuscitation. 2014 Aug.

Abstract

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.

Keywords: Arterial blood pressure; Cardiac arrest; Cardiopulmonary resuscitation.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Mean coronary perfusion pressure during each minute of CPR between survivors and non-survivors after hypoxic ventricular fibrillation. Similar results were also seen in normoxic VF model. Error bars represent SEM. Modified from Sutton et al., Resuscitation 2013.
Fig. 2
Fig. 2
Percentage of patients achieving return of spontaneous circulation (ROSC) during adult cardiac arrest resuscitation. Modified from Paradis et al., Journal of the American Medical Association 1990.
See this image and copyright information in PMC

References

    1. Merchant RM, Yang L, Becker LB, et al. Incidence of treated cardiac arrest in hospitalized patients in the United States. Crit Care Med. 2011;39:2401–6. - PMC - PubMed
    1. Berg RA, Sutton RM, Holubkov R, et al. Ratio of PICU versus ward cardiopulmonary resuscitation events is increasing. Crit Care Med. 2013;41:2292–7. - PMC - PubMed
    1. Girotra S, Nallamothu BK, Spertus JA, et al. Trends in survival after in-hospital cardiac arrest. N Engl J Med. 2012;367:1912–20. - PMC - PubMed
    1. Neumar RW, Otto CW, Link MS, et al. Part 8: Adult advanced cardiovascular life support: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122(Suppl. 3):S729–67. - PubMed
    1. Kleinman ME, Chameides L, Schexnayder SM, et al. Part 14: Pediatric advanced life support: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122(Suppl. 3):S876–908. - PubMed

Publication types