Ever seen cardiopulmonary resuscitation performed on a TV drama such as Gray’s Anatomy or ER and wondered when doctors know it’s time to call it quits? Well, it turns out to be more art than science, a decision that â€Å"tends to be individualized,†said Dr. Joshua Kosowsky, clinical director of the emergency medicine department at Brigham and Women’s Hospital.
But a new study could lead doctors to wait a little longer before they stop the chest compressions for hospitalized patients in cardiac arrest. The research, published in the journal Lancet, found that patients were slightly more likely to survive and live long enough to be discharged from hospitals where doctors continued performing CPR for an average of 25 minutes, compared with hospitals where they gave up after an average of 16 minutes.
â€Å"It should prompt hospitals to review their practices and consider changes if their resuscitation efforts fall short,†according to experts who spoke with the New York Times.
Kosowsky, however, said that while the study was intriguing, â€Å"it’s difficult to say†from the small survival benefit whether the duration of CPR really does increase survival rates or whether it’s just an association that’s due to some other factor. For example, those hospitals with longer CPR attempts might treat lower-risk patients or have somewhat different procedures in other aspects that make survival more likely.
â€Å"Certainly, for an individual patient, the duration of resuscitative attempts has, if anything, an inverse relationship with outcome,†he added, such as an increased risk of permanent brain damage or the placement of a breathing tube attached to a ventilator.
Doctors in the Brigham ER tend to end CPR after 20 to 30 minutes, depending on the individual set of circumstances, and Kosowsky said â€Å"this is unlikely to change any time soon.â€Â
Deborah Kotz can be reached at dkotz@globe.com. Follow her on Twitter @debkotz2.
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