Top Things to Know: 2019 ILCOR CoSTR
Published: November 14, 2019
- Over 350,000 EMS-assessed cardiac arrests and 209,000 in-hospital cardiac arrests occur annually in the US. Despite advances in resuscitation science, survival rates are only at best 10%.
- This is the third in a series of annual International Consensus on Cardiopulmonary Resuscitation (ILCOR) consensus on science with treatment recommendations (CoSTR) summaries that is based on ILCOR’s new adoption of continuous evidence evaluation (CEE). The CEE process enables the review of resuscitation and first aid science as it becomes available and disseminates the appropriate updated information to the public rapidly. Historically, ILCOR conducted a comprehensive evaluation of resuscitation science every five years. In 2015, ILCOR decided to implement a CEE process.
- This third annual ILCOR CoSTR summary includes an update of resuscitation and first aid science. Within the past year, ILCOR reviewed many topics including adult and pediatric basic and advanced life support, neonatal life support, education and first aid.
- This year’s annual summary document includes ILCOR’s evidence review of 7 ILCOR CoSTR’s encompassing basic and advanced life support in adult and pediatric populations, neonatal life support, education and first aid with GRADE methodology analyses and treatment recommendations.
- In this summary document, values and preferences have been added to provide greater insight into the rationale for treatment recommendations and task forces prioritized the top three knowledge gaps for each topic.
- Updates to recommendations for advanced life support in adults include advanced airway interventions during cardiac arrest, the use of vasopressors in cardiac arrest, and extracorporeal cardiopulmonary resuscitation (ECPR) for cardiac arrest. Recommendations for basic life support in adults address Dispatch Assisted CPR (DA-CPR) during cardiac arrest. The ILCOR Task Force on Education, in partnership with Adult Life Support, updated the recommendations for transport to cardiac arrest centers (CAC’s).
- Pediatric recommendations for basic life support were updated regarding Dispatcher-Assisted CPR (DA-CPR) during cardiac arrest, advanced airway interventions in pediatric cardiac arrest, the use of ECPR in infants and children and pediatric Targeted Temperature Management (TTM) after cardiac arrest.
- Neonatal life support recommendations include updates for initial oxygen concentration for term and preterm infants at birth.
- First Aid addressed presyncope and the use of physical countermeasures in adults and children.
- Survival from both in-hospital cardiac arrest (IHCA) and out-of-hospital Cardiac arrest (OHCA) has increased over the past decade, but there is still tremendous potential for improvement. The treatment recommendations in this 2019 ILCOR CoSTR summary for adult and pediatric advanced life support and CPR quality aim to provide information on the role of antiarrhythmic drugs for cardiac arrest.
Citation
Soar J, Maconochie I, Wyckoff MH, Olasveengen TM, Singletary EM, Greif R, Aickin R, Bhanji F, Donnino MW, Mancini ME, et al. 2019 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: summary from the Basic Life Support, Advanced Life Support, Pediatric Life Support, Neonatal Life Support, Education, Implementation, and Teams, and First Aid Task Forces [published online ahead of print November 14, 2019]. Circulation. doi: 10.1161/CIR.0000000000000734.