Cardiac Arrest: Analysis Identifies Futility Markers

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When cardiac arrest occurs out-of-hospital knowing when resuscitation efforts should be continued for the maintenance of potentially viable organs is crucial and findings from a new study suggest that three markers may inform that decision.

Results from a retrospective analysis of data from three cohorts totalling almost 7,000 patients with OHCA showed that there was 0% chance of survival in patients whose OHCA was not witnessed by emergency medical services (EMS) personnel, who had nonshockable initial cardiac rhythm, and in whom there was no return of spontaneous circulation before receipt of a third 1-mg dose of epinephrine.

Both the specificity and the positive predictive value for death before hospital discharge of these objective criteria were 100% in the 3 cohorts, Xavier Jouven, MD, PhD, from the Hôpital Européen Georges Pompidou in Paris, and colleagues reported online in the Annals of Internal Medicine.

“Our results may help with decision-making about uncontrolled donation after cardiac death (UDCD),” they said. While resuscitation must always focus first on patient survival, UDCD can be considered once this is no longer feasible, they suggested.

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