Basic and extended cardiopulmonary resuscitation in children – recommendations 2025
https://doi.org/10.33667/2078-5631-2026-11-14-19
Abstract
Modern international guidelines for cardiopulmonary resuscitation (CPR) increasingly emphasize an individualized, physiologically oriented approach to managing patients after cardiac arrest. The updated protocols for advanced life support in children by the European Resuscitation Council (ERC PALS, 2025) confirm the key role of high-quality CPR as the basis for a successful outcome. It emphasizes the importance of maintaining an optimal frequency and depth of chest compressions, minimizing interruptions, and preventing hyperventilation. At the same time, attention is shifting to achieving target physiological parameters, primarily diastolic pressure (≥25 mmHg in infants and ≥30 mmHg in children over one year of age) and end-tidal carbon dioxide concentration (ETCO2) as markers of CPR effectiveness. A number of innovations concern the timing and sequence of adrenaline administration, the priority of rapid defibrillation in shock rhythms, and the management of the post-resuscitation period, where the main focus has been on actively preventing hyperthermia (maintaining a temperature of ≤37.5 °C) and maintaining blood pressure above the 10th percentile for age. The new data highlights the need for a multifactorial neurological prediction that does not rely on a single isolated test. Thus, the new guidelines from the American Heart Association and the American Academy of Pediatrics (AHA/AAP) aim to improve the effectiveness of CPR, personalize post-resuscitation care, and enhance long- term neurological outcomes in pediatric patients.
About the Authors
O. Yu. Popov
Peoples’ Friendship University of Russia named after Patrice Lumumba (RUDN University) ; Kaluga State University named after K.E. Tsiolkovsky ; Antonius Medvision Emergency Medical Center
Russian Federation
Russian Federation
Popov Oleg Yu., PhD Med Sci, associate professor at Dept of Disaster Medicine, associate professor, acting head of Dept of Emergency and Tactical Medicine, Medical Institute, Director
Moscow; Kaluga
V. A. Mitish
Peoples’ Friendship University of Russia named after Patrice Lumumba (RUDN University) ; A.V. Vishnevsky National Medical Research Center of Surgery
Russian Federation
Russian Federation
Mitish Valery A., PhD Med Sci, associate professor, head of Dept of Disaster Medicine, head of Dept of Wounds and Wound Infections
Moscow
M. A. Borodina
Peoples’ Friendship University of Russia named after Patrice Lumumba (RUDN University)
Russian Federation
Russian Federation
Borodina Maria A., Dr Med Sci (habil.), professor at Dept of Disaster Medicine
Moscow
O. K. Yusupov
Kaluga State University named after K.E. Tsiolkovsky ; Antonius Medvision Emergency Medical Center
Russian Federation
Russian Federation
Yusupov Odildzhon K., employee
Kaluga
A. A. Misinchuk
Kaluga State University named after K.E. Tsiolkovsky ; Antonius Medvision Emergency Medical Center
Russian Federation
Russian Federation
Misinchuk Andrey A., employee
Kaluga
Y. V. Kvyatkovskiy
N.A. Semashko Research and Educational Institute of Clinical Medicine, Russian University of Medicine
Russian Federation
Russian Federation
Kvyatkovskiy Yaroslav V., laboratory assistant at Dept of Emergency Medical Care, Faculty of Medicine
Moscow
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Review
For citations:
Popov O.Yu., Mitish V.A., Borodina M.A., Yusupov O.K., Misinchuk A.A., Kvyatkovskiy Y.V. Basic and extended cardiopulmonary resuscitation in children – recommendations 2025. Medical alphabet. 2026;1(11):14-19. (In Russ.) https://doi.org/10.33667/2078-5631-2026-11-14-19
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