Cardiopulmonary and cerebral resuscitation

The future of cardiopulmonary resuscitation lies in new technologies for monitoring and generating vital organ perfusion during cardiac arrest and the post-resuscitation phase and in pharmacologic agents that will enhance ROSC and reverse ischemia-reperfusion injury. ROSC is the first step toward survival, so interventions that improve ROSC deserve further investigation. Long-term survival with good neurologic recovery is the critical endpoint. Interventions recommended for clinical practice must therefore demonstrate improved long-term survival. The resources required to provide many of the interventions discussed in this article, principally invasive perfusion technologies, cannot be justified unless there is clear benefit. The allocation of such resources to provide intensive resuscitation and post-resuscitation support will need to be addressed from medical and societal viewpoints.