Part 11: Post–Cardiac Arrest Care: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Karen G. Hirsch, Edilberto Amorim, Patrick J. Coppler, Ian R. Drennan, Andrea Elliott, Alexandra June Gordon, Jacob C. Jentzer, Nicholas J. Johnson, Ari Moskowitz, Bryn E. Mumma, Alex Presciutti, Amber J. Rodriguez, Albert F. Yen, Jon C. Rittenberger
Abstract
Cardiac arrest is common and deadly, affecting up to 700 000 people in the United States annually. Advanced cardiac life support measures are commonly employed to improve outcomes. This 2025 guideline on adult post-cardiac arrest care from the American Heart Association summarizes the most recent published evidence for and recommendations on several important areas of post-cardiac arrest management. Based on structured evidence reviews, guidelines are provided for initial blood pressure, oxygen, ventilation, and glucose goals. Evidence evaluating the routine use of antibiotics after return of spontaneous circulation is reviewed. The update also reviews diagnostic testing modalities, temperature control goals and duration, and the use of percutaneous coronary intervention and mechanical circulatory support in the patient resuscitated from cardiac arrest. New data regarding the detection and management of seizures have been incorporated, along with updates regarding the timing and modalities used in neuroprognostication. These guidelines now differentiate prognostication for favorable versus unfavorable outcome. New sections on the utility of advanced neuromonitoring, along with definitions and treatment options for myoclonus, are included to guide the clinician. Expanded recommendations regarding how to optimize survivorship for patients, caregivers, and rescuers are reviewed. Finally, the potential role of organ donation in the patient resuscitated from cardiac arrest is reviewed.