The objective of the Working Group in formulating these statements is to guide healthcare professionals in practicing appropriate clinical nutrition in the ICU, with a focus on improving quality of care, which will translate into improved patient outcomes.
Objective. To increase the awareness of the existence of return of spontaneous circulation after cessation of cardiopulmonary resuscitation in the intensive care setting. Setting. 28-bed medical surgical intensive care unit in a 600-bed tertiary care hospital. Patient and participant. Single patient. Return of spontaneous circulation after cessation of cardio pulmonary resuscitation. Interventions. A middle-aged female patient with multiple medical problems and digoxin toxicity was admitted to the ICU. With the start of heamodialysis, the patient had ventricular fibrillation necessitating the initiation of CPR. In view of unresponsiveness and poor chance of discharge from ICU, CPR was withheld after 12 minutes of advanced cardiac life support. Measurements and results. While the ECG leads were still connected, spontaneous pulse and blood pressure were noted after 3 minutes. The patient thereafter had normal mental function for 12 days and then died of severe sepsis later whilst still on the ICU. Conclusions. Healthcare providers at all levels in the ICU should be aware of return of spontaneous circulation after cessation of cardio pulmonary resuscitation. They should exercise caution while certifying death and informing the family of this immediately after termination of CPR.
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