Cardiopulmonary Resuscitation (CPR) must be attempted if indicated, not done if it is not indicated or if the patient does not accept or has previously rejected it and withdrawn it if it is ineffective. If CPR is considered futile, a Do-Not-Resuscitate Order (DNR) will be recorded. This should be made known to all physicians and nurses involved in patient care. It may be appropriate to limit life-sustaining-treatments for patients with severe anoxic encephalopathy, if the possibility of clinical evolution to brain death is ruled out. After CPR it is necessary to inform and support families and then review the process in order to make future improvements. After limitation of vital support, certain type of non-heart-beating-organ donation can be proposed. In order to acquire CPR skills, it is necessary to practice with simulators and, sometimes, with recently deceased, always with the consent of the family. Research on CPR is essential and must be conducted according to ethical rules and legal frameworks.
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http://dx.doi.org/10.1016/j.medin.2010.04.013 | DOI Listing |
Ann Emerg Med
January 2025
Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria. Electronic address:
Study Objective: Extracorporeal cardiopulmonary resuscitation (eCPR) is a rescue therapy for selected patients when conventional cardiopulmonary resuscitation (CPR) fails. Current evidence suggests that the success of eCPR depends on well-structured in- and out-of-hospital protocols. This article describes the Vienna eCPR program, and the interventions implemented to improve clinical processes and patient outcomes.
View Article and Find Full Text PDFJ Vet Emerg Crit Care (San Antonio)
January 2025
Center for Interdisciplinary Statistical Education and Research, Washington State University, Pullman, Washington, USA.
Objective: To evaluate the effect of rescuer team size on objective skill measures of basic life support (BLS) and advanced life support (ALS) using high-fidelity canine CPR simulation.
Design: Prospective, experimental study.
Setting: Veterinary clinical simulation center.
Resusc Plus
December 2024
Division of Cardiology, Department of Medicine, University of Minnesota School of Medicine, Minneapolis, MN, United States.
Background: Extracorporeal life support (ECLS) provides organ perfusion in refractory cardiac arrest but during the initiation of ECLS mean arterial pressure (MAP) and carotid flow may be suboptimal due to hypotension and/or insufficient flow. We hypothesized that cardiopulmonary resuscitation (CPR) in addition to ECLS may increase carotid flow and MAP compared to ECLS alone.
Methods: Observational pilot study comparing hemodynamic parameters before and after CPR cessation in pigs supported by ECLS for experimental refractory cardiac arrest.
Ren Fail
December 2025
Emergency Medicine Clinical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Background: Acute kidney injury (AKI) is a common complication in heart failure (HF) patients. Patients with heart failure who experience renal injury tend to have a poor prognosis. The objective of this study is to examine the correlation between the occurrence of AKI in heart failure patients and different mean arterial pressure (MAP) trajectories, with the goal of improving early identification and intervention for AKI.
View Article and Find Full Text PDFResuscitation
January 2025
Department of Emergency Medicine, University of New Mexico, Albuquerque, NM; Department of Emergency Medicine, University of Iowa, Iowa City, IA; Texas Emergency Medicine Research Center, McGovern Medical School, Houston, TX. Electronic address:
Background: Factors contributing to worse outcomes for out-of-hospital cardiac arrests (OHCA) from minoritized communities are poorly understood. We sought to evaluate the impact of receiving hospital performance on OHCA outcome disparities.
Methods: We performed a retrospective cohort study of non-traumatic OHCAs from the National Cardiac Arrest Registry to Enhance Survival from 2013-2022 that survived hospital admission.
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