Dear Editor,
We thank De Roux et al. for their interest and comments on our review of in-hospital cardiac arrest [1]. We agree completely that perioperative cardiac arrest has many specific features that make it very different from the circumstances of other causes of in-hospital cardiac arrest. Perioperative cardiac arrests are excluded from some in-hospital cardiac arrest studies for this reason. The epidemiology, treatment and outcome from perioperative cardiac arrest warrant a separate review—we certainly did not have enough space within our review to do justice to the topic. The clinical practice recommendations made by the Perioperative Cardiac Arrest (PERIOPCA) Consortium are potentially helpful [2], as are guidelines published previously by another international group [3, 4]. Unfortunately, it is unlikely that we will ever have high-certainty evidence to inform clinical guidelines on the treatment of perioperative cardiac arrest. Best practice guidance inevitably varies depending on which expert group is providing the advice. Currently, the International Liaison Committee on Resuscitation (ILCOR) has the most comprehensive international representation of any group of resuscitation experts but has yet to review the science and publish treatment recommendations on perioperative cardiac arrest. The Advanced Life Support Task Force of ILCOR may review this topic in the future and may be informed partly by the findings of the Royal College of Anaesthetists 7th National Audit Project (NAP7) [5]. The NAP7 steering group has reviewed all perioperative cardiac arrests occurring in UK hospitals over a 1-year period and will report its findings in a series of papers in 2023.
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Both authors collaborated in manuscript drafting and reviewed the final draft of the manuscript.
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Competing interests
James Penketh declares no competing interests. Jerry P. Nolan receives payment from Elsevier (Editor-in-Chief of Resuscitation) and is a Board member of European Resuscitation Council and the International Liaison Committee on Resuscitation and a member of the NAP7 Steering Group.
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References
- 1.Penketh J, Nolan JP. In-hospital cardiac arrest: the state of the art. Crit Care. 2022;26(1):376. doi: 10.1186/s13054-022-04247-y. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Chalkias A, Mongardon N, Boboshko V, Cerny V, Constant AL, De Roux Q, Finco G, Fumagalli F, Gkamprela E, Legriel S, et al. Clinical practice recommendations on the management of perioperative cardiac arrest: a report from the PERIOPCA Consortium. Crit Care. 2021;25(1):265. doi: 10.1186/s13054-021-03695-2. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Moitra VK, Einav S, Thies KC, Nunnally ME, Gabrielli A, Maccioli GA, Weinberg G, Banerjee A, Ruetzler K, Dobson G, et al. Cardiac arrest in the operating room: resuscitation and management for the anesthesiologist: part 1. Anesth Analg. 2018;126(3):876–888. doi: 10.1213/ANE.0000000000002596. [DOI] [PubMed] [Google Scholar]
- 4.McEvoy MD, Thies KC, Einav S, Ruetzler K, Moitra VK, Nunnally ME, Banerjee A, Weinberg G, Gabrielli A, Maccioli GA, et al. Cardiac arrest in the operating room: part 2-special situations in the perioperative period. Anesth Analg. 2018;126(3):889–903. doi: 10.1213/ANE.0000000000002595. [DOI] [PubMed] [Google Scholar]
- 5.Kane AD, Armstrong RA, Kursumovic E, Cook TM, Oglesby FC, Cortes L, Moppett IK, Moonesinghe SR, Agarwal S, Bouch DC, et al. Methods of the 7(th) National audit project (NAP7) of the Royal College of Anaesthetists: peri-operative cardiac arrest. Anaesthesia. 2022;77(12):1376–1385. doi: 10.1111/anae.15856. [DOI] [PMC free article] [PubMed] [Google Scholar]
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