Advanced Cardiovascular Life Support: Focus on Airway Management, Vasopressor Selection, and Rescue Therapy with Extracorporeal Membrane Oxygenation

THE LAST major update to the American Heart Association guidelines on advanced cardiac life support was in 2015. Given that the body of published evidence regarding these interventions has grown considerably since then, a new focused update recently was published. The evidence for this update of the 2015 guidelines was taken from a recent international consensus about cardiopulmonary resuscitation.

The purpose of this freestanding editorial to is provide a perspective on this important update for the perioperative cardiothoracic and vascular community, including the applications of advanced airway strategies, vasopressors, and extracorporeal cardiopulmonary resuscitation in the setting of cardiac arrest. These revised recommendations are examined in more detail from the perspective of the cardiovascular anesthesiologist. This perspective also examines some of the ways that these recommendations diverge from emerging special considerations for cardiac arrest in the perioperative setting. These considerations have developed from concerns that the generic recommendations for cardiopulmonary resuscitation do not fully address our specific patient populations or the very specific events that may ensue. Cardiac anesthesiologists may be called upon during cardiac arrest because of their advanced expertise in cardiopulmonary resuscitation. It remains essential that the evidence and guidelines surrounding cardiac arrest in our patient populations be familiar to us all.