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December 22, 1945

TREATMENT OF THE AGONAL STATE AND OF CLINICAL DEATH

JAMA. 1945;129(17):1226. doi:10.1001/jama.1945.02860510092025

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Abstract

To the Editor:—  Study of the physiology and therapy of the agonal state in animal experiments and of these problems in man led me to the conclusion that arteriovenous transfusion of blood with epinephrine and glucose added to it, combined with vigorous artificial respiration, are the most important factors in the process of resuscitation. Today we may consider it established that death of the organism does not always take place as a sudden cessation of life. Biologic or irrevocable death is usually preceded by what is termed clinical death diagnosed because of cessation of cardiac and respiratory activity. During this period of clinical death, which does not last more than five or six minutes, the tissues and organs have not had sufficient time to undergo irreversible changes. Clinical death, therefore, is merely a qualitative expression of the process of dying. In a number of cases the transition from life to

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