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February 1991

Resuscitation of Patients With Metastatic Cancer: Is Transient Benefit Still Futile?

Author Affiliations

Minneapolis, Minn

Arch Intern Med. 1991;151(2):235-239. doi:10.1001/archinte.1991.00400020011003

Thirty years ago Kouwenhoven et al1 presented their experience with closed-chest cardiopulmonary resuscitation (CPR), ushering in an era of new possibilities for postponing death. Initially, CPR was restricted to acute care facilities and was employed in specific situations (generally when an acute cardiac catastrophe occurred in a previously stable patient) at the discretion of the responsible physician. Over the decades, thousands of medical personnel and lay persons have been trained, and CPR is performed in extended care facilities, in homes, and on the street. In most acute care hospitals, CPR at the time of clinical death has become the standard of care. Patient consent for this procedure is presumed, although a patient may refuse ahead of time and a do not resuscitate (DNR) order will be written. In the absence of a DNR order, all patients receive CPR. As experience accumulates with resuscitation of a wide range of patients

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