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November 1992

Cardiopulmonary Resuscitation in Chronically Ill Patients in the Intensive Care Unit: Does Poor Outcome Justify Withholding Cardiopulmonary Resusciation From This Group?

Author Affiliations

Department of Medicine Veterans Affairs Medical Center 1400 Veterans of Foreign Wars Pkwy West Roxbury, MA 02132

Arch Intern Med. 1992;152(11):2181-2183. doi:10.1001/archinte.1992.00400230007001

Since cardiopulmonary resuscitation (CPR) was described in 1960 by Kouwehoven et al,1 National Conferences have been held every 5 to 7 years to determine at first how to implement this innovation and, subsequently, to update the methodology for resuscitation.1-5 We now confront this technology as an important part of a problem that has made dying itself a process that is complex and seemingly difficult to achieve even by those who would welcome it. Lay persons have been trained in CPR in large numbers and have contributed significantly as "first responders" to life-saving in cases of prehospital sudden death. Widespread public education in CPR has also resulted in an expectation that CPR will be implemented in virtually all cases should cardiopulmonary arrest occur in the hospital. Cardiopulmonary resuscitation has become so ingrained in in-hospital practice that it has come to be seen as an independent patient right that, when

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