New CPR guidelines: What changed?

Post-cardiac arrest oxygen and CO2 targets, seizure prophylaxis, more

New guidelines on cardiopulmonary resuscitation in adults were published in Circulation in November 2024. They’re 187 pages long.

What’s changed, and what do you need to know?

Who Writes the CPR Guidelines?

The International Liaison Committee on Resuscitation (ILCOR) is comprised of experts on resuscitation around the world. ILCOR is a scientific advisory body to the American Heart Association and similar societies in other countries. The committee convenes and issues recommendations periodically; the American Heart Association (AHA) generally then incorporates ILCOR’s recommendations into its published guidelines, which set the standard of care for cardiac arrest and resuscitation in the U.S.

How Evidence-Based Are the CPR Guidelines?

Most of the CPR guidelines are based on a very low-quality body of evidence (retrospective observational studies, simulation-based studies, etc). Although millions of cardiac arrests happen each year globally, high-quality clinical research on resuscitation is very difficult to conduct, due in part to challenges in obtaining consent and randomization.

Unless otherwise noted, the CPR guidelines referenced here are ILCOR’s weak recommendations based on low-certainty evidence.