Cardiac arrest occurs rapidly, requires high timeliness in treatment, and has a poor prognosis. Cardiopulmonary resuscitation (CPR) is a key intervention to save the lives of patients with cardiac arrest. In recent years, CPR has made significant progress with the update of evidence-based research and technological development. The evolution of specific recommendations in international guidelines reflects the changes in the certainty of and understanding about emerging evidence. To unravel the logical progression of cognitive development in the CPR field, this review systematically clarifies the evidence base and evolutionary history of recommendations for core components of adult CPR, including the chain of survival, interruptions in compressions, high-quality CPR, early defibrillation, dispatcher-assisted CPR, extracorporeal CPR, and temperature control. Moreover, it identifies knowledge gaps and proposes potential development directions to provide systemic insights and strategic thinking in CPR for providers, researchers, and healthcare administrators.
Zheng et al. (2026) studied this question.