Open AccessThe prognostic value of agonal respiration in refractory cardiac arrest: a case series of non‐shockable cardiac arrest successfully resuscitated through extracorporeal cardiopulmonary resuscitation
Author(s) -
Bunya Naofumi,
Wada Kenshiro,
Yamaoka Ayumu,
Kakizaki Ryuichiro,
Katayama Yoichi,
Kasai Takehiko,
Kyan Ryoko,
Murakami Naoto,
Kokubu Nobuaki,
Uemura Shuji,
Narimatsu Eichi
Publication year - 2019
Publication title -
acute medicine and surgery
Language(s) - English
Resource type - Journals
ISSN - 2052-8817
DOI - 10.1002/ams2.398
Subject(s) - extracorporeal cardiopulmonary resuscitation , medicine , extracorporeal membrane oxygenation , cardiopulmonary resuscitation , clinical death , refractory (planetary science) , pulseless electrical activity , ventricular fibrillation , resuscitation , ventilation (architecture) , mechanical ventilation , anesthesia , cardiology , mechanical engineering , physics , astrobiology , engineering
Background Agonal respiration following out‐of‐hospital cardiac arrest is associated with favorable neurological outcomes. Resuscitation using extracorporeal membrane oxygenation could contribute to achieving favorable neurological outcomes in patients with refractory cardiac arrest. Case presentation We report two cases of refractory cardiac arrest with non‐shockable rhythms and agonal respiration; both patients were successfully resuscitated through extracorporeal cardiopulmonary resuscitation (ECPR). Both patients were breathing spontaneously upon arrival. One patient was asystolic and the other experienced pulseless electrical activity followed by ventricular fibrillation. Agonal respiration was observed in both and ECPR was implemented, leading to a favorable neurological outcome at discharge. Conclusion The presence of agonal respiration has the potential to confer a favorable neurological outcome in patients with refractory cardiac arrest if maintained, even when the initial cardiac rhythm is not shockable. In these cases, resuscitation should not be abandoned, and ECPR should be considered.