The International Liaison Committee on Resuscitation—Review of the last 25 years and vision for the future

doi:10.1016/j.resuscitation.2017.09.029

Resuscitation

Volume 121, December 2017, Pages 104-116

https://doi.org/10.1016/j.resuscitation.2017.09.029 Get rights and content

Abstract

2017 marks the 25th anniversary of the International Liaison Committee on Resuscitation (ILCOR). ILCOR was formed in 1992 to create a forum for collaboration among principal resuscitation councils worldwide. Since then, ILCOR has established and distinguished itself for its pioneering vision and leadership in resuscitation science.

By systematically assessing the evidence for resuscitation standards and guidelines and by identifying national and regional differences, ILCOR reached consensus on international resuscitation guidelines in 2000, and on international science and treatment recommendations in 2005, 2010 and 2015. However, local variation and contextualization of guidelines are evident by subtle differences in regional and national resuscitation guidelines. ILCOR’s efforts to date have enhanced international cooperation, and progressively more transparent and systematic collection and analysis of pertinent scientific evidence. Going forward, this sets the stage for ILCOR to pursue its vision to save more lives globally through resuscitation.

Section snippets

History of ILCOR

The first stimulus to the foundation of the International Liaison Committee on Resuscitation (ILCOR) was in 1990 [1]. Members of the European Resuscitation Council (ERC), American Heart Association (AHA), Australian Resuscitation Council (ARC), Heart and Stroke Foundation of Canada (HSFC), and the Resuscitation Council of Southern Africa (RCSA) gathered at Utstein Abbey [2] in Stavanger, Norway to discuss the lack of standardized language in reports on out-of-hospital cardiac arrest. This led

Basic life support and automated external defibrillation (BLS/AED)

The 1997 ILCOR advisory statement summarised the sequence of actions for a lay rescuer to treat a cardiac arrest victim and comprised an assessment of consciousness, airway, breathing and circulation (pulse check) [154]. Resuscitation was started with 2 rescue breaths followed by 15 chest compressions (rate 100 min, depth 4–5 cm). In 2000, the pulse check was removed from lay resuscitation guidelines and the rescuer was instead prompted to assess consciousness and look for the absence of normal

Impact on process and outcomes

At the time that ILCOR was born, in the early 1990s, survival rates from out-of-hospital cardiac arrest (OHCA) were generally very poor and broadly in the range of 2–6% [163], [164], [165], [166]. A systematic review of OHCA studies from 1950 to 2008 that was published in 2010 concluded rather disappointingly that the survival rate from OHCA worldwide had not changed throughout this 30 year period [163]. This lack of progress in OHCA outcomes was particularly disappointing given the

ILCOR strategic plan

In 2015, ILCOR’s Co-Chairs, Vinay Nadkarni and Gavin Perkins launched a comprehensive strategic planning process coordinated by Bill Montgomery to develop a five-year strategic plan for ILCOR. A two-day retreat in Singapore in 2016, attended by 43, representing all ILCOR member councils refreshed the vision, mission and value for ILCOR (Table 3 and Electronic Supplementary Material). Four key strategic pillars underpinned the strategy: continuous evidence evaluation and task forces; leadership,

Conclusion

ILCOR has delivered international consensus on science and treatment recommendations for the last 25 years. ILCOR’s refreshed vision, mission and values sets the stage for future collaboration and sustainable growth. Today’s priorities are to deliver continuous evidence evaluation to enable the world’s resuscitation scientists and practitioners to receive the most up to date and relevant information to their practice. Expanding the global reach of ILCOR is a key priority for enabling ILCOR to

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Out-of-hospital cardiac arrest is a major public health problem worldwide due to its high burden and poor outcomes. Despite progress in treatment, patient outcomes remain unsatisfactory, particularly in low-resource settings. The establishment of a registry is the first step towards gaining a comprehensive understanding of prevailing local conditions and identifying potential opportunities for improving patient survival. Here, we provide a narrative review of the BASeline Investigation of Out-of-hospital Cardiac Arrest (BASIC-OHCA), the first national OHCA registry in China, to introduce its development history, current state, challenges and future directions. We aim to enhance cross-cultural understanding by providing insights from China, while also serving as a reference for the implementation of large-scale registries in low-resource settings.
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Incidence, process of care, and outcomes of out-of-hospital cardiac arrest in China: a prospective study of the BASIC-OHCA registry
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Out-of-hospital cardiac arrest (OHCA) is an important global public health issue, but its epidemiology and outcomes in low-income and middle-income countries remain largely unknown. We aim to comprehensively describe the incidence, process of care, and outcomes of OHCA in China.
In the prospective, multicentre, population-based Baseline Investigation of Out-of-hospital Cardiac Arrest (BASIC-OHCA) registry study, participating sites were selected from both urban and rural areas in all seven geographical regions across China. All patients with OHCA assessed by emergency medical service (EMS) staff were consecutively enrolled from Aug 1, 2019, to Dec 31, 2020. Patients with suspected cardiac arrest assessed by bystanders whose return of spontaneous circulation was achieved without the need for defibrillation or EMS personnel cardiopulmonary resuscitation were excluded. Patients with all key variables missing were excluded, including resuscitation attempt, age, sex, witnessed status, cause, all process of care indicators, and all outcome measures. In this analysis, we included data for EMS agencies serving 25 monitoring sites (20 urban and five rural) that included the entire serving population, data for the whole of 2020, and at least 50 OHCA patients in 2020. Data were collected and reported using the Utstein template. We calculated the crude incidence of EMS-assessed OHCA in 2020. We also report data on baseline characteristics (including sex, cause, location of OHCA, and presence of shockable rhythm), process of care (including EMS response time, cardiopulmonary resuscitation, defibrillation, and advanced life support), and outcomes of non-traumatic OHCA between Aug 1, 2019, and Dec 31, 2020, including survival and survival with favourable neurological outcomes at discharge or 30 days, and at 6 and 12 months.
Of 115·1 million people served by the 25 participating sites, 132 262 EMS-assessed patients with OHCA were enrolled, and resuscitation was attempted for 42 054 (31·8%) patients between Aug 1, 2019, and Dec 31, 2020. The crude incidence of EMS-assessed OHCA was 95·7 per 100 000 population (95% CI 95·6–95·8) in 2020. Among 38 227 individuals with non-traumatic OHCA, 25 958 (67·9%) were male, 30 282 (79·2%) had a cardiac arrest at home, 32 523 (85·1%) had a presumed cardiac cause, and 2297 (6·0%) presented with an initial shockable rhythm. 4049 (11·5%) of 35 090 patients with an unwitnessed or bystander-witnessed OHCA received dispatcher-assisted cardiopulmonary resuscitation and 7121 (20·3%) received bystander cardiopulmonary resuscitation; only 14 (<0·1%) patients were assessed by bystanders with an automated external defibrillator. The median EMS response time was 12 min (IQR 9–16). At hospital discharge or 30 days, 441 (1·2%) of 38 227 survived, 304 (0·8%) survived up to 6 months, and 269 (0·7%) up to 12 months. At hospital discharge or 30 days, 309 (0·8%) survived with favourable neurological outcomes, 257 (0·7%) had favourable neurological outcomes at 6 months, and 236 (0·6%) at 12 months.
Our findings revealed a high burden of EMS-assessed OHCA with a low proportion of resuscitation attempts. The suboptimal implementation of chain of survival and unsatisfactory prognosis call for national efforts to improve the care and outcomes of patients with OHCA in China.
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Special paperThe International Liaison Committee on Resuscitation—Review of the last 25 years and vision for the future

Abstract

Section snippets

History of ILCOR

Basic life support and automated external defibrillation (BLS/AED)

Impact on process and outcomes

ILCOR strategic plan

Conclusion

Resuscitation

Ann Emerg Med

Lancet

Resuscitation

Ann Emerg Med

Resuscitation

Resuscitation

Resuscitation

Resuscitation

Resuscitation

Resuscitation

Resuscitation

Resuscitation

Resuscitation

Resuscitation

Resuscitation

Resuscitation

Resuscitation

Standards for Systematic Reviews

Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews

BMC Med Res Methodol

GRADE: an emerging consensus on rating quality of evidence and strength of recommendations

BMJ

Part 2: evidence evaluation and management of conflicts of interest: 2015 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations

Resuscitation

Recommended guidelines for uniform reporting of data from out-of-hospital cardiac arrest: the ‘Utstein style' European Resuscitation Council, American Heart Association, Heart and Stroke Foundation of Canada and Australian Resuscitation Council

Eur J Anaesthesiol

Recommended guidelines for uniform reporting of data from out-of- hospital cardiac arrest: the Utstein Style Task Force of the American Heart Association, the European Resuscitation Council, the Heart and Stroke Foundation of Canada, and the Australian Resuscitation Council

Ann Emerg Med

Circulation

Recommended guidelines for reviewing, reporting, and conducting research on in-hospital resuscitation: the in-hospital ‘Utstein style'. American Heart Association

Circulation

Advisory Statements of the International Liaison Committee on Resuscitation

Circulation

Single-rescuer adult basic life support: an advisory statement from the Basic Life Support Working Group of the International Liaison Committee on Resuscitation

Circulation

The universal advanced life support algorithm: an advisory statement from the Advanced Life Support Working Group of the International Liaison Committee on Resuscitation

Circulation

Early defibrillation: an advisory statement from the Advanced Life Support Working Group of the International Liaison Committee on Resuscitation

Circulation

Special resuscitation situations. An advisory statement on conditions which may require modifications in resuscitation procedures or techniques. Prepared by members of the International Liaison Committee on Resuscitation

Resuscitation

Part 1: introduction to the international guidelines 2000 for CPR and ECC. a consensus on science

Resuscitation

Part 1: introduction to the international guidelines 2000 for CPR and ECC: a consensus on science

Circulation

Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care: international consensus on science, Part 2: ethical aspects of CPR and ECC

Circulation

Part 2: ethical aspects of CPR and ECC

Resuscitation

Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care: international consensus on science, part 3: adult basic life support

Circulation

Part 3: adult basic life support

Resuscitation

Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care: international consensus on science, part 4: the automated external defibrillator: key link in the chain of survival

Circulation

Part 4: the automated external defibrillator: key link in the chain of survival. European Resuscitation Council

Resuscitation

Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care: international consensus on science, Part 5: new guidelines for first aid

Circulation

Part 5: new guidelines for first aid

Resuscitation

Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Part 6: advanced cardiovascular life support: section 1: Introduction to ACLS 2000: overview of recommended changes in ACLS from the guidelines 2000 conference

Circulation

Part 6: advanced cardiovascular life support − section 1: introduction to ACLS 2000: overview of recommended changes in ACLS from the guidelines 2000 conference

Resuscitation

Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care, part 6: advanced cardiovascular life support: section 2: defibrillation

Circulation

Part 6: advanced cardiovascular life support. section 2: defibrillation. European Resuscitation Council

Resuscitation

Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Part 6: advanced cardiovascular life support: section 3: adjuncts for oxygenation, ventilation and airway control

Circulation

Special paper
The International Liaison Committee on Resuscitation—Review of the last 25 years and vision for the future