The thin line between life and death

Base excess and lactate as prognostic indicators for patients treated by extra corporeal life support after out hospital cardiac arrest due to acute coronary syndrome

“…The median lactate for the high mortality group was 17 mmol/l (11-25); this was significantly higher than the level of the low mortality group: 11 mmol/l (8-12, p = 0.01). At H0, there was no difference between the two groups (lactate of the high-risk group 21 mmol/l (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29); lactate of the low-risk group 19 mmol/l (11-28, p = 0.8).…”

“…The line between death and life is thin 24 and there is currently no clear consensus on the indications of ECLS for refractory CA. ECLS is an effective method 4 but is expensive and time consuming justifying early detection of death to not follow treatment without hope of recovery.…”

Ethical and Legal Implications of Elective Ventilation and Organ Transplantation: “Medicalization” of Dying versus Medical Mission

“…Defining death, like defining life, continues to be a challenge [1]. Death can be considered in terms of medical, legal, ethical, philosophical, societal, cultural, and religious rationales.…”

Protocols for Uncontrolled Donation After Circulatory Death: A Comprehensive Approach to Refractory Cardiac Arrest

“…[3][4][5] When should the goal change from saving the patient's brain and heart, for life, to preserving organs for transplantation? [3][4][5] Our proposal would not only improve cost-effectiveness results, but also would clarify the status of patient-donors: by exploring all of the possibilities of high-quality cardiopulmonary and cerebral resuscitation, it minimizes the conflict of interest identified in EMS and ED professionals and the risk of compromising the treatment of these patients. 1 The proposal consists of implementing a comprehensive approach to refractory cardiac arrest and to subordinate the option of organ donation until after the failure of such an approach.…”

“…[2][3][4][5] By implementing such a strategy, we avoid the identified conflicts of interest, 1-5 because we are really still treating a patient, rather than only preserving his or her organs. Additionally, consent is required and public confidence in the system remains, and the health care community avoids the misunderstanding impression of hastening death.…”