Chinese Clinical Practice Guidelines for the Device Therapy of Adult Post-Cardiac Arrest Syndrome(2023 Update)

Title: Chinese Clinical Practice Guidelines for the Device Therapy of Adult Post-Cardiac Arrest Syndrome(2023 Update)
Edition: Updated
Classification: Standard guideline
Field: Comprehensive guideline
Countries and regions: China
Guidelines users: Medical care personnel of Emergency Department, Critical Care Units, Respiratory and Critical Care Department, Cardiology Department and Cardiac Surgery Department, general medicine practitioners, researchers and teaching staff working on the treatment of PCAS.
Evidence classification method: GRADE
Development unit: Taskforce of Chinese Clinical Practice Guidelines for the Device Therapy of Adult Post-Cardiac Arrest Syndrome
Registration time: 2023-07-04
Registration number: PREPARE-2023CN457
Purpose of the guideline: During cardiac arrest (CA), severe ischemia and hypoxia occur in the tissues and organs of the body, leading to the release of inflammatory factors and the production of various metabolites. After ROSC, reperfusion injury occurs, leading to multiple organ dysfunction or dysfunction in the body, known as post cardiac arrest syndrome (PCAS). In China, the incidence of CA is about 407/100000 (95% CI: 381/100000~43/100000), and the overall success rate of resuscitation is only 4.0%. Among patients with out of hospital cardiac arrest (OHCA), the survival rate after discharge is only 1%. PCAS is closely related to the prognosis of CA patients and is an independent risk factor affecting the survival rate of resuscitation patients. More and more research evidence suggests that active intervention after ROSC can significantly improve the survival rate and neurological prognosis of PCAS patients. The American Heart Association Guidelines for Cardiopulmonary resuscitation and Cardiovascular First Aid updated in 2010 added the fifth link to the "life chain", namely, comprehensive treatment after Cardiopulmonary resuscitation, and proposed treatment measures for PCAS, such as improving tissue and organ perfusion, treating primary diseases, and preventing recurrent cardiac arrest. In 2020, the American Heart Association Guidelines for Cardiopulmonary resuscitation and Cardiovascular First Aid was updated to emphasize once again that post resuscitation treatment is an important part of the "survival chain", and it is recommended to achieve the best treatment effect through comprehensive, structured and multidisciplinary cooperation. Referring to the international consensus of the International Resuscitation Liaison Committee in 2020- recommendations on Cardiopulmonary resuscitation and cardiovascular emergency treatment, the European Resuscitation Committee and the European Society of Intensive Care Medicine updated the Guidelines for Post resuscitation Treatment in 2021. In order to guide and standardize our clinicians' understanding and use of device support treatment in the diagnosis and treatment of PCAS, the project team will adopt the Evidence-based medicine method to build a clinical practice guide for PCAS device support treatment in the context of our population in February 2022, to guide and standardize the clinical diagnosis and treatment decisions of device support treatment in the treatment of PCAS in China. However, with the passage of time, the Evidence-based medicine evidence covered by the guide has been updated, so the project team decided to update the guide.