Management and prevention of in-hospital cardiac arrest: present and future

Cardiac arrest is most commonly defined as the cessation of cardiac mechanical activity requiring either delivery of chest compressions and/or defibrillation. The condition is often subdivided into in-hospital cardiac arrest (IHCA) and out-of-hospital cardiac arrest (OHCA) based on different locations, but also differences in epidemiology, natural history, co-morbidities, process of care, and provider characteristics. Both are complex conditions that warrant ongoing research to improve management, but IHCA appears to have received disproportionately less investigative attention. Recent reviews of over 150 randomized controlled trials (RCTs) conducted between 1995 and 2019 reported that the vast majority (>80%) were focused on OHCA, approximately 10% on both and <10% were focused solely on IHCA. In this review, we will provide an overview of current knowledge regarding IHCA epidemiology, management and prevention, while also identifying opportunities for future research.