Personalized physiology-guided resuscitation in highly monitored patients with cardiac arrest-the PERSEUS resuscitation protocol

Heart Fail Rev. 2019 Jul;24(4):473-480. doi: 10.1007/s10741-019-09772-7.

Abstract

Resuscitation guidelines remain uniform across all cardiac arrest patients, focusing on the delivery of chest compressions to a standardized rate and depth and algorithmic vasopressor dosing. However, individualizing resuscitation to the appropriate hemodynamic and ventilatory goals rather than a standard "one-size-fits-all" treatment seems a promising new therapeutic strategy. In this article, we present a new physiology-guided treatment strategy to titrate the resuscitation efforts to patient's physiologic response after cardiac arrest. This approach can be applied during resuscitation attempts in highly monitored patients, such as those in the operating room or the intensive care unit, and could serve as a method for improving tissue perfusion and oxygenation while decreasing post-resuscitation adverse effects.

Keywords: Cardiac arrest; Monitoring; Pathophysiology; Physiology-guided treatment; Resuscitation.

Publication types

  • Review

MeSH terms

  • Blood Pressure / physiology
  • Capnography / methods
  • Cardiopulmonary Resuscitation / methods
  • Cardiopulmonary Resuscitation / standards*
  • Clinical Protocols*
  • Coronary Circulation / physiology
  • Heart Arrest / physiopathology
  • Heart Arrest / therapy*
  • Humans
  • Monitoring, Physiologic
  • Neuroprotection / physiology
  • Oxygen Inhalation Therapy / methods
  • Positive-Pressure Respiration / methods
  • Precision Medicine / methods*