Recognize Gasping in Patients with Out-of-Hospital Cardiac Arrest — But Don't Stop Compressions!

The presence of an initial shockable rhythm (ventricular tachycardia or ventricular fibrillation) has previously been shown to be associated with improved survival in patients with out-of-hospital cardiac arrest (NEJM JW Emerg Med May 2014 and Resuscitation 2014; 85:905). However, little is known about the prognostic implications of agonal or gasping respirations in such patients. These researchers retrospectively reviewed data from a large prospectively collected database to determine whether gasping during out-of-hospital cardiac arrest is independently associated with 1-year survival with favorable neurological outcome (defined as Cerebral Performance Category score ≤2).

Of 1827 patients, 177 (10.8%) had gasping respirations at some point…