The new European Resuscitation Council guidelines on cardiopulmonary resuscitation and post-resuscitation care: great opportunities for anaesthesiologists

Böttiger, B. W. (2016) European Journal of Anaesthesiology. 33(10). pp.701-704


Every 5 years and under the umbrella of the International Liaison Committee on Resuscitation ( – representing resuscitation councils from all parts of the world – the ‘International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations’ is derived from the scientific analysis of all published studies in the field of resuscitation.1 Based on the results of this worldwide collaboration, and using the highest possible levels of scientific evidence, the European Resuscitation Council (ERC) has produced the new ERC guidelines on cardiopulmonary resuscitation (CPR) and post-resuscitation care. They were published on 15 October 2015 and are available at and consist of more than 1000 pages2.

Several of the 2015 key recommendations can already be found in the previous CPR guidelines because, for consistency, we have kept key messages from 2010 whenever possible, and we have made relevant and important changes where required by new evidence. The most important new recommendations aimed at increasing survival following out-of-hospital cardiac arrest highlight a marked increase in lay resuscitation rates, ‘telephone CPR’ by dispatch centres, first responder systems, ‘cardiac arrest centres’ and prognostication. A major new initiative in the 2015 ERC guidelines is the recommendation to educate school children in CPR – worldwide.2

Sudden cardiac death with unsuccessful out-of-hospital CPR is responsible for more than 350 000 unexpected deaths every year in the European Union3 and, based on extrapolation from the US data, this is ranked third in the causes of death in industrialised nations after cancer and other cardio-circulatory diseases.4 This unacceptable situation can be improved markedly and the 2015 ERC guidelines for CPR show how this may be achieved.

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Cardiopulmonary resuscitation and post-resuscitation care

Mackenney, J. & Soar, J. Anaesthesia & Intensive Care Medicine. Available online: 18 January 2016


Survival following cardiac arrest depends on early recognition and effective treatment with high-quality chest compressions with minimal interruption, ventilation, treatment of reversible causes, and defibrillation if appropriate.

Successfully resuscitated patients can develop a ‘SIRS-like’ post-cardiac arrest syndrome.

Post-cardiac arrest care includes coronary reperfusion, control of oxygenation and ventilation, circulatory support, glucose control, treatment of seizures, and therapeutic hypothermia. Prognostication in comatose survivors is challenging.

Approximately one-third of cardiac arrest survivors admitted to intensive care are discharged home.

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