title: How long should resuscitative efforts be continued in adult out-of-hospital cardiac arrest?
abstract: The neurological prognosis of out-of-hospital cardiac arrest (OHCA) is extremely poor, particularly in patients who require prolonged cardiopulmonary resuscitation (CPR). However, the upper limit of CPR duration is unclear. We present a case of a 51-year-old man with nonhypothermic OHCA. He was discharged without neurological sequelae despite long duration CPR lasting 143 minutes, which is the longest duration among adult nonhypothermic OHCA cases reported. There are some patients for whom CPR duration might not be associated with prognosis. To determine when to terminate resuscitative efforts or whether more lifesaving medical resources should be provided, a prognostic indicator other than CPR duration is needed.
authors.affiliation: Department of Emergency and Critical Care Medicine, Hitachi General Hospital, Ibaraki, Japan; Department of Emergency and Critical Care Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. Electronic address: tatsumafukuda-jpn@umin.ac.jp.
authors.forename: Tatsuma
authors.initials: T
authors.lastname: Fukuda
authors.affiliation: Department of Emergency and Critical Care Medicine, Hitachi General Hospital, Ibaraki, Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Nakamura
authors.affiliation: Department of Emergency and Critical Care Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Fukuda-Ohashi
authors.affiliation: Department of Emergency and Critical Care Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Yahagi
mesh_terms: D000328:Adult; D000638:Amiodarone / Q000008:administration & dosage; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage; D016887:Cardiopulmonary Resuscitation / Q000379:methods / Q000592:standards; D004554:Electric Countershock; D004632:Emergency Medical Services; D004636:Emergency Service, Hospital; D004837:Epinephrine / Q000008:administration & dosage; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage; D014693:Ventricular Fibrillation / Q000628:therapy*
chemical_list: D000889:Anti-Arrhythmia Agents; D014662:Vasoconstrictor Agents; D000638:Amiodarone; D004837:Epinephrine