How long should resuscitative efforts be continued in adult out-of-hospital cardiac arrest?

Abstract

The neurological prognosis of out-of-hospital cardiac arrest (OHCA) is extremely poor, particularly in patients who require prolonged cardiopulmonary resuscitation (CPR). However, the upper limit of CPR duration is unclear. We present a case of a 51-year-old man with nonhypothermic OHCA. He was discharged without neurological sequelae despite long duration CPR lasting 143 minutes, which is the longest duration among adult nonhypothermic OHCA cases reported. There are some patients for whom CPR duration might not be associated with prognosis. To determine when to terminate resuscitative efforts or whether more lifesaving medical resources should be provided, a prognostic indicator other than CPR duration is needed.