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Media Release: 2024 ILCOR Consensus on Science with Treatment Recommendations (CoSTR)

The International Liaison Committee on Resuscitation (ILCOR) has published its latest Consensus on Science with Treatment Recommendations (CoSTR), outlining vital updates in resuscitation science and post-cardiac arrest care. Our 2024 CoSTR, has been developed by global experts, to offer evidence-based recommendations to improve patient outcomes.

Key Highlights of the 2024 ILCOR CoSTR:

  1. Firm Surfaces for CPR: CPR on a firm surface remains critical for effectiveness; however, it is essential to avoid delays in CPR initiation.
  2. Post-ROSC Blood Pressure Targets: For adults following cardiac arrest, maintaining a mean arterial pressure of at least 60-65mmHg is suggested. For children, targeting a systolic blood pressure above the 10th percentile for age is recommended.
  3. Management of Seizures Post-ROSC: Both adults and children who experience seizures after ROSC should receive treatment. Seizure prophylaxis is not advised.
  4. ECMO in Select Paediatric Cases: Extracorporeal Membrane Oxygenation (ECMO) may be considered in specific paediatric cases, including those with signs of pulmonary hypertensive crisis or refractory cardiac arrest, either as a bridge to recovery or as part of an organ transplant evaluation.
  5. Delayed Umbilical Cord Clamping: For preterm infants (<37 weeks) not requiring immediate resuscitation, delaying cord clamping for at least 60 seconds is recommended.
  6. Therapeutic Hypothermia for Newborns in Low-Resource Settings: Therapeutic hypothermia is suggested for term newborns with moderate-to-severe hypoxic-ischemic encephalopathy in low- and middle-income countries, provided a supportive neonatal care setting is available.
  7. Cognitive Aids for Healthcare Professionals: Cognitive aids are suggested for healthcare professionals involved in resuscitation; however, these aids are not recommended for laypersons performing CPR.
  8. Gamified Learning in Resuscitation Education: The CoSTR suggests consideration of gamified learning methods to enhance resuscitation education.
  9. Rapid-Cycle Deliberate Practice in Training: Incorporating rapid-cycle deliberate practice in resuscitation training is encouraged to improve skill retention.
  10. First Aid for COPD Patients: First aid providers trained to administer supplemental oxygen should use pulse oximetry and aim for an oxygen saturation of 88-92% in patients with a history of COPD.

These recommendations emphasize practical and innovative approaches to improving survival and recovery rates for patients undergoing resuscitation. The ILCOR CoSTR serves as a global treatment recommendations, supporting healthcare providers and lay people in delivering effective, science-based resuscitation care.

For more information see:

Circulation: https://www.ahajournals.org/doi/10.1161/CIR.0000000000001288

Resuscitation: https://www.resuscitationjournal.com/article/S0300-9572(24)00308-3/fulltext

For the Full COSTR see the CoSTR Website: https://costr.ilcor.org/