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
. 2026 Jan;42(1):1-21.
doi: 10.1016/j.ccc.2025.08.001. Epub 2025 Sep 13.

Physiology-Guided CPR

Affiliations
Review

Physiology-Guided CPR

Lindsay N Shepard et al. Crit Care Clin. 2026 Jan.

Abstract

Current cardiopulmonary resuscitation (CPR) guidelines rely on standardized metrics, yet substantial evidence reveals significant variability in patients' physiologic responses. Physiology-directed CPR represents an innovative approach aimed at improving cardiac arrest outcomes by tailoring resuscitation efforts to patient-specific physiologic responses rather than rescuer performance alone. Data indicate that intra-arrest markers including arterial blood pressure, end-tidal carbon dioxide, and cerebral oximetry are associated with cardiac arrest outcomes and can potentially be targeted during CPR. This article explores the underlying physiology, supporting data, advantages, and limitations of these monitoring strategies, highlighting the promise of a shift toward physiology-directed, precision-based resuscitation practices.

Keywords: Blood pressure; Cardiac arrest; Cardiopulmonary resuscitation; End-tidal carbon dioxide; Physiology.

PubMed Disclaimer

Conflict of interest statement

Disclosures Drs L.N. Shepard and A. DeVivo report no conflicts of interest. Dr B.S. Abella reports research support from the National Institutes of Health (NIH), Avive and Becton Dickinson, equity in MDAlly, Neuroptics, consultancy to Stryker, National Basketball Association, and Becton Dickinson. Dr R.W. Morgan reports research support from the NIH.

MeSH terms