The decision to forgo CPR in the elderly patient

Abstract

CARDIOPULMONARY resuscitation (CPR) is attempted in one third of those who die in American hospitals. One third of these patients survive the initial resuscitation effort; one third of the survivors leave the hospital; 80% of these individuals will be alive six months later; and 60% will be alive five years later. Half of those who receive CPR are more than 65 years of age. The majority of the survivors remember nothing about the experience except a sore chest on awakening. Most long-term survivors resume their previous activity, but almost half decide to forgo CPR in the future and 2% of the survivors will be left in the persistent vegetative state.1-4 As these data suggest, long-term survivors of cardiopulmonary arrest have run a daunting biologic gauntlet. Full recovery from cardiopulmonary arrest is a test of the responsiveness of the cardiopulmonary system, the tolerance of the brain to global ischemia, and