Wolf Creek XVII Part 5: Mobile AEDs

Wolf Creek XVII Part 6: Physiology-Guided CPR

Introduction

Physiology-guided cardiopulmonary resuscitation (CPR) offers the potential to optimize resuscitation and enable early prognosis.

Methods

Physiology-Guided CPR was one of six focus topic for the Wolf Creek XVII Conference held on June 14-17, 2023 in Ann Arbor, Michigan, USA. International thought leaders and scientists in the field of cardiac arrest resuscitation from academia and industry were invited. Participants submitted via online survey knowledge gaps, barriers to translation and research priorities for each focus topic. Expert panels used the survey results and their own perspectives and insights to create and present a preliminary unranked list for each category, which was then debated, revised and ranked by all attendees to identify the top 5 for each category.

Results

Top knowledge gaps include identifying optimal strategies for the evaluation of physiology-guided CPR and the optimal values for existing patients using patient outcomes. The main barriers to translation are the limited usability outside of critical care environments and the training and equipment required for monitoring. The top research priorities are the development of clinically feasible and reliable methods to continuously and non-invasively monitor physiology during CPR and prospective human studies proving targeting parameters during CPR improves outcomes.

Conclusion

Physiology-guided CPR has the potential to provide individualized resuscitation and move away from a one-size-fits-all approach. Current understanding is limited, and clinical trials are lacking. Future developments need to consider the clinical application and applicability of measurement to all healthcare settings. Therefore, clinical trials using physiology-guided CPR for individualisation of resuscitation efforts are needed.

Wolf Creek XVII Part 1: The future of cardiac arrest resuscitation

The Wolf Creek Conference, initiated in 1975, is a well-established tradition providing a unique forum for robust intellectual exchange between thought leaders and scientists from academia and industry focused on advancing the science and practice of cardiac arrest resuscitation. The Wolf Creek XVII Conference was hosted by the Max Harry Weil Institute for Critical Care Research and Innovation in Ann Arbor, Michigan, USA on June 15-17, 2023. A major focus of the conference proceedings was to identify and prioritize the knowledge gaps, barriers to translation, and research priorities for six major domains in the field of resuscitation: (1) automated cardiac arrest diagnosis, (2) amplifying lay-responder response, (3) mobile AEDs, (4) physiology-guided CPR, (5) extracorporeal support, and (6) neuroprotection. In addition, industry scientists were given the opportunity to present and discuss cutting edge innovations. Finally, building off of the conference's theme of "The Future of Cardiac Arrest Resuscitation", the Weil Institute introduced the "Wolf Creek Innovator in Cardiac Arrest and Resuscitation Award" to recognize early career investigators who were challenging current paradigms in resuscitation science. Similar to the early Wolf Creek Conferences, the goal was to fuel active discussion and debate among leading experts to determine where future research efforts should be focused. This manuscript provides an overview of the Wolf Creek XVII conference, and the individual manuscripts within this special edition of Resuscitation Plus describe the conference proceedings and outcomes in more detail. It is our intent that these publications will provide a roadmap for important academic and commercial advances in the field of cardiac arrest resuscitation.

Wolf Creek XVII Part 2: The origin, evolution, and impact of the Wolf Creek Conference

The Wolf Creek Conference is a seminal meeting of resuscitation researchers that has significantly influenced scientific advances and patient care in the field of cardiac arrest resuscitation over nearly half a century. Originating in 1975 at the Wolf Creek Lodge in Georgia, the conference was founded by Drs. James Elam, James Jude, and Peter Safar with the aim of improving clinical practices in cardiopulmonary resuscitation (CPR) by stimulating laboratory and clinical research. Over 17 conferences to date, the scope has broadened to encompass the growing field of resuscitation science, participation has expanded to include thought leaders and scientists from both academia and industry, and the proceedings have catalyzed numerous innovations in field. This narrative review highlights the genesis, objectives, proceedings, and impact of the Wolf Creek Conference from 1975 to the present.