International Liaison Committee on Resuscitation Identifies CPR Knowledge Gaps

The International Liaison Committee on Resuscitation identified knowledge gaps in the field of resuscitation medicine concerning recommendations on cardiopulmonary resuscitation (CPR) guidelines. These findings were recently published in Circulation.

Task forces from the International Liaison Committee on Resuscitation identified questions, and evidence was evaluated by performing systematic reviews on the published literature. Each systematic review was accompanied by a list of knowledge gaps identified by the task forces as they wrote treatment recommendations that were frequently qualified as weak on the basis of low-quality evidence. The current publication communicated those knowledge gaps with the goal of targeting inquiries to close the gaps in knowledge.

Selected knowledge gap categories are listed below, along with identified gaps:

Automated External Defibrillators

Training/Protocols for Dispatcher-Assisted Recognition of Cardiac Arrest and Interventions to Promote Bystander CPR

Influence of dispatcher backgrounds, methods to overcome language barriers, and optimal instruction sequence

System Configuration for Public-Access Defibrillation

Where to place automated external defibrillators for public access?

CPR Quality

Which of the individual components of chest compressions should be prioritized when delivering CPR?

Advanced Life Support

Tracheal Intubation During CPR

Type and duration of training required for performing advanced airway management during CPR

Vasopressors During Cardiac Arrest

Dose and timing of epinephrine administration during cardiac arrest

Emergency Angiography in Comatose Patients After Return of Spontaneous Circulation

Which subgroups of patients with non-ST-segment elevation are the most likely to benefit?

Pediatric Life Support

Optimal Sequence of Interventions for Pediatric Basic Life Support

Whether the cause of the suspected cardiac arrest should influence the resuscitation sequence

Numeric physiological parameters for end tidal CO₂ and diastolic blood pressure associated with high-quality pediatric CPR

The study authors wrote, “Despite tremendous progress in the field of resuscitation medicine, multiple knowledge gaps remain.” They added, “This consensus statement has outlined the major topic areas and attempted to prioritize the gaps in knowledge on the basis of the potential impact on outcomes and feasibility to perform.”

Reference

Kleinman M, Perkins G, Bhanji F, et al. ILCOR scientific knowledge gaps and clinical research priorities for cardiopulmonary resuscitation and emergency cardiovascular care [published online April 26, 2018]. Circulation. doi:10.1161/CIR.0000000000000561