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ILCOR Pediatric Life Support 2025: What is New and Why it Matters?

Jhuma Sankar1, Shreeshail Benakanal2, Akshita Soni2

  • 1Division of Pediatric Pulmonology and Intensive Care, Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), New Delhi, India. jhumasankar@aiims.edu.

Indian Journal of Pediatrics
|June 26, 2026
PubMed

Insights

The 2025 ILCOR update enhances pediatric resuscitation with ten key changes, focusing on early CPR, improved airway management, and physiology-guided interventions to boost survival and neurologic outcomes in children.

Area of Science:

  • Pediatric Emergency Medicine
  • Resuscitation Science
  • Critical Care

Background:

  • The 2025 International Liaison Committee on Resuscitation (ILCOR) Pediatric Life Support (PLS) update addresses critical areas in pediatric resuscitation.
  • Evidence-based reviews of 39 PICOST questions informed the significant revisions.

Purpose of the Study:

  • To outline the ten major changes in the 2025 ILCOR PLS guidelines.
  • To improve the timeliness, quality, and physiologic precision of pediatric resuscitation efforts.
  • To enhance survival and neurologic outcomes for pediatric patients requiring resuscitation.

Main Methods:

  • Systematic review of 39 PICOST questions.
  • Analysis of evidence to update resuscitation algorithms and recommendations.
  • Focus on physiological targets and goal-directed interventions.

Main Results:

  • Early cardiopulmonary resuscitation (CPR) is emphasized for bradycardia with poor perfusion.
  • Pediatric early warning systems (PEWS) are reinforced for early detection of deterioration.
  • Bag-mask ventilation reaffirmed as initial airway technique; both ABC and CAB sequences accepted for CPR.
  • Updated defibrillation guidance (2-4 J/kg, anteroposterior pads) and withdrawal of the 10-second pulse check rule.
  • Rhythm-specific epinephrine timing and new hemodynamic targets (e.g., diastolic blood pressure, ETCO2 >20 mmHg) introduced.
  • Post-arrest care includes systolic blood pressure goals and multimodal neuro-prognostication.

Conclusions:

  • The 2025 ILCOR PLS update signifies a move towards clearer, physiology-based, goal-directed resuscitation.
  • These revisions aim to optimize interventions for better pediatric patient outcomes.
  • Updated guidelines provide a framework for enhanced pediatric life support practices.

Keywords:
ILCORInternational Liaison Committee on ResuscitationPediatric Advanced Life Support (PALS)Pediatric life support

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