Delaying Withdrawal of Care in the ICU After Cardiac Arrest May Result in More Survivors

One in five survivors of cardiac arrest with care withdrawn in the first three days was predicted to survive neurologically intact if the withdrawal decision had been delayed.

Providers are tempted to prognosticate outcomes for critically ill patients, including those resuscitated after cardiac arrest, possibly leading to decisions to withdraw life support early. Unfortunately, no reliable methods exist to predict which patients will do poorly, and a previous multicenter study estimated that 26% of patients with cardiac arrest could have survived, with 16% neurologically intact, if withdrawal of care had been delayed (Resuscitation 2016; 102:127).

Using an international observational registry of cardiac arrest patients, researchers matched 459 patients who had care withdrawn within 3 days of cardiac arrest to 1162 who did not. Of those without early withdrawal, 43% survived with good neurologic outcome. Based on p…

Reviewing Author

Jason T. McMullan, MD, MS, FAEMS

Disclosures

Consultant/Advisory BoardEMCREG International

Grant/Research SupportNIH; Department of Defense

Editorial BoardsJournal of Emergency Medical Services

Leadership Positions in Professional SocietiesNational Association of EMS Physicians (Chair, Research Committee)