The evidence supporting AHA guidelines on adult cardiopulmonary resuscitation (CPR)

• DOI: 10.1371/journal.pone.0309241
• Publication Date: 2024-12-17T18:26:02Z
• Authors: Emma Junedahl; Peter Lundgren; Erik Andersson; Vibha Gupta; Truls Råmunddal; Aidin Rawshani; Araz Rawshani; Gabriel Riva; Ida Arnetorp; Fredrik Hessulf; Johan Herlitz; Therese Djärv
• Keywords: Expert opinion; Evidence-Based Medicine

Background Guidelines for the management of cardiac arrest play a crucial role in guiding clinical decisions and care. We examined strength quality evidence underlying these recommendations order to elucidate strengths gaps knowledge. Methods Using 2020 American Heart Association (AHA) Adult CPR, we subdivided all into advanced life support (ALS), basic (BLS), recovery after arrest, as well more granular categorization by topic (i.e. intervention or evaluation recommended). The Class Recommendation (COR) Level Evidence (LOE) each were reviewed. Additionally, reviewed 2023 guidelines ensure inclusion most recent updates. Results noted 254 recommendations, which 181 ALS, 69 BLS, 4 resuscitation. In total, only 2 (1%) had robust (LOE A), while 23% at LOE B-NR (Non-Randomized), 15% B-R (Randomized), 50% C-LD (Limited Data), 12% relied on expert opinion C-EO (Expert Opinion). Despite ALS (Class 1, 2a, 2b), none A. no supported For 7% C (C-LD C-EO). specific BLS topics, such airway management, was notably low. Among neurological prognostication relatively stronger evidence. Conclusions Only 26 out 81 COR 1 (32%) A B, indicating strong discrepancy between recommendation guidelines. findings underscore pressing need rigorous research, particularly randomized trials.