Advanced Hemodynamic Monitoring During Postresuscitation Care After Out-of-Hospital Cardiac Arrest: Protocol for a Scoping Review

Introduction: Out-of-hospital cardiac arrest (OHCA) is associated with high mortality and substantial long-term neurological sequelae among survivors. During postresuscitation intensive care after return of spontaneous circulation (ROSC), myocardial dysfunction, vasoplegia, and mixed shock states are often observed. Arterial blood pressure alone may not adequately reflect tissue perfusion or oxygen delivery. Advanced hemodynamic profiling has the potential to improve individualized postresuscitation management, but the overall evidence base has not been comprehensively mapped. Aims: This scoping review will map the available evidence on advanced hemodynamic monitoring during early postresuscitation care after adult OHCA (< 72 h after ROSC). Specifically, we will characterize which hemodynamic variables are measured, when and how they are measured, and in which clinical contexts; summarize how studies report associations between these variables and outcomes or markers of organ perfusion/function; and identify methodological gaps in hemodynamic monitoring. Methods: A scoping review will be conducted, including adult (≥ 18 years) patients hospitalized after OHCA with sustained ROSC. Eligible studies must investigate one or more predefined advanced hemodynamic parameters using invasive or non-invasive techniques beyond arterial pressure monitoring. There are no restrictions on comparators, publication year, language, setting, or publication type. Animal, pediatric, simulation, intra-arrest-only studies, microcirculatory/local perfusion studies, and echocardiography-only studies are excluded. MEDLINE (via PubMed) will be searched from inception to 31 January 2026. Two reviewers will screen and extract data independently in duplicate using Covidence. Data will be synthesized descriptively. Conclusions: This review will provide a comprehensive overview of advanced hemodynamic monitoring after OHCA and identify evidence and gaps in the research in this area.