Cardiopulmonary resuscitation (CPR) algorithms generally begin with clear instructions: in the absence of a pulse, begin CPR. When to end resuscitative efforts, though, is much less obvious. Current guidelines and clinical algorithms do not offer specific guidance on when to stop resuscitation for in-hospital cardiac arrest. Resuscitation may be prematurely terminated when survival is possible, or alternatively, may be continued when futile. Among patients who receive CPR for 30 minutes or longer, about 1.8% survived to hospital discharge. At the same time, among those who survived to hospital discharge after return of spontaneous circulation, 3% received CPR for longer than 30 minutes, indicating that in some cases, patients can survive even after very long resuscitations.

Read Full Article