Anaes · Perioperative cardiac arrest
Perioperative cardiac arrest
Also known as Perioperative cardiac arrest · Intraoperative cardiac arrest · Intraoperative CPR · NAP7 · Anaesthesia-related arrest · 4 Hs 4 Ts · Perimortem caesarean
Perioperative cardiac arrest for the fellowship exams: NAP7 incidence, causes and outcomes, the ERC 2025 adult ALS drugs and shocks, the ERC 2025 modifications for the operating room, and the special causes an anaesthetist meets: LAST, malignant hyperthermia, anaphylaxis, hyperkalaemia, arrest after cardiac surgery and maternal arrest.
Checked against its sources on 23 Oct 2026
Practise this topic
On this page
Study tools
Your progress
Saved on this device.
Target exams
Red flags
- Start chest compressions if the systolic blood pressure suddenly decreases below 50 mmHg, in association with a fall in ETCO2, despite appropriate interventions (ERC 2025).
- Always address hypoxia, hypovolaemia, electrolyte disorders, hypothermia, cardiac tamponade, tension pneumothorax, thrombosis and toxic agents (ERC 2025).
Meet the patient
A 65-year-old man becomes profoundly hypotensive during an emergency laparotomy for bleeding; the arterial line shows a systolic pressure below 50 mmHg and the ETCO2 falls. The ERC 2025 guidance is to start chest compressions if the systolic blood pressure suddenly decreases below 50 mmHg, in association with a fall in ETCO2, despite appropriate interventions.[4]
References5ShowHide
- [1]Armstrong RA, Soar J, Kane AD, et al. Peri-operative cardiac arrest: epidemiology and clinical features of patients analysed in the 7th National Audit Project of the Royal College of Anaesthetists. Anaesthesia, 2024.PMID 37972476
- [2]Armstrong RA, Cook TM, Kane AD, et al. Peri-operative cardiac arrest: management and outcomes of patients analysed in the 7th National Audit Project of the Royal College of Anaesthetists. Anaesthesia, 2024.PMID 37972480
- [3]Soar J, Böttiger BW, Carli P, et al. European Resuscitation Council Guidelines 2025 Adult Advanced Life Support Resuscitation 215 (2025) 110769, 2025.Source
- [4]Lott C, Karageorgos V, Abelairas-Gomez C, et al. European Resuscitation Council Guidelines 2025 Special Circumstances in Resuscitation Resuscitation 215 (2025) 110753, 2025.Source
- [5]Frerk C, Mitchell VS, McNarry AF, et al. Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults. British journal of anaesthesia, 2015.PMID 26556848