The thin line between life and death

Excerpt

Historically, death was defined by the irreversible cessation of breathing and pulse. This view has been challenged with the development of recent sophisticated life support techniques. It has been shown that the heart can be “restarted” after cardiac arrest and patients can be resuscitated. These developments are summarized in the recent updates of the guidelines of the European Resuscitation Council [1] and the American Heart Association [2]. Despite numerous studies, the blood flow generated during cardio-pulmonary resuscitation (CPR) is often insufficient to meet metabolic requirements, providing only very short-term support, and the probability of return of spontaneous circulation decreases rapidly. Every minute under CPR adds significant mortality and (neurologic) morbidity. So, despite advances in modern CPR technologies, outcome after CPR remains poor [3]. The transport of cardiac arrest victims under continuous CPR is controversial [4], and outcome depends on various external factors [5]. …