Abstract
We sent out questionnaires on the timing and condition for the discontinuation of cardiopulmonary resuscitation (CPR) in cardiac arrest patients to 392 elder members of the Japanese Society of Reanimatology, Japan Society of Intensive Care Medicine and Japan Society of Anesthesiology, and received 229 replies (58.4%) . The results were as follows: Important factors in the decision of discontinuation of CPR were, 1) whether the cardiac arrest occurred more than 30 min before the start of CPR, 2) cardiac standstill on ECG, 3) terminal stage of cancer, and 4) massive traumatic injury including burn. The most respondents usually performed CPR for about 30 min in cases where the cardiac arrest occurred less than 30 min prior to initiation of CPR, but the CPR time is extended to over 1 h in previously healthy victims, victims under 15 y/o, arresting time less than 5 min, hypothermia of 25°C or less, and in victims without history of critical basic disorders. If closed chest CPR is not effective, 46% of respondents are willing to perform open chest CPR and 28% cardiopulmonary bypass procedure. The respondents requested our committee to produce a manual for the discontinuance of CPR. At present, it is not feasible for our committee to make the manual, but we are planning to make a guideline.
