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May 1995

Improved Survival After Intraoperative Cardiac Arrest in Noncardiac Surgical Patients

Arch Surg. 1995;130(5):560. doi:10.1001/archsurg.1995.01430050110020

The article "Improved Survival After Intraoperative Cardiac Arrest in Noncardiac Surgical Patients" by Girardi and Barie1 in the January issue of the Archives is a worthwhile addition to the few articles on the subject that address the issue via a survey of large numbers of cases from a single institution over a relatively long time span.2 The Invited Commentary by Flint3 overlooks the fact that, after correction for type of operation, the ratio of cardiac arrest to number of operations has not changed appreciably over the last 35 or 40 years. The central problem is that while anesthetic agents and adjuvant drugs have changed, one invariant has remained, the so-called anesthesia record.

Although it is true that during anesthesia one observes the patient, important decisions are not made on the basis of any one instantaneous observation but rather on the basis of the information accrued from the

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