Return of spontaneous circulation is obviously a favourable outcome from cardiac arrest but significant numbers of these patients do not survive to hospital discharge. It would be advantageous, for both the patient and their relatives, if it were possible to predict in the immediate post-resuscitation phases whether or not long-term survival was likely or even possible.
It would be unethical to deny patients ongoing care if survival was possible so any method that predicts outcome must be entirely reliable. No tests currently exist to determine outcome in the first few hours (Resuscitation Council UK and ERC 2000). Various types of tests and investigations are under review, including blood tests (levels of S-100 protein) and assessment of activity in the brain (electroencephalograph, EEG). Assessment at three days is of far greater reliability than immediately after circulation is restored.
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