Gasping during cardiac arrest

Current Opinion in Critical Care

Volumn 15, Issue 3, 2009, Pages 185-188

  Zuercher, Mathias ^a   Ewy, Gordon A ^b,c  

^a UNIVERSITY HOSPITAL BASEL   (Switzerland)

^b UNIVERSITY OF ARIZONA   (United States)

^c UNIVERSITY OF ARIZONA COLLEGE OF MEDICINE   (United States)

Author keywords

Cardiac arrest; Gasping; Resuscitation; Spontaneous breathing

Indexed keywords

ANOXIA; AORTA PRESSURE; ARTIFICIAL VENTILATION; ASPHYXIA; ASSISTED VENTILATION; BRAIN STEM; BREATHING DISORDER; BREATHING RATE; CARDIAC PATIENT; CAROTID ARTERY FLOW; COMPRESSIVE STRENGTH; CORONARY ARTERY BLOOD FLOW; EMERGENCY HEALTH SERVICE; GASPING; HEART ARREST; HEART ATRIUM PRESSURE; HEART MUSCLE CONTRACTILITY; HEART OUTPUT; HEART VENTRICLE FIBRILLATION; HOSPITAL DISCHARGE; HUMAN; INCIDENCE; INTRACRANIAL PRESSURE; MEDULLA OBLONGATA; NONHUMAN; OXYGEN TENSION; PATIENT CARE; POSITIVE END EXPIRATORY PRESSURE; PRESSURE GRADIENT; PREVALENCE; RESUSCITATION; REVIEW; SUDDEN INFANT DEATH SYNDROME; SURVIVAL RATE; THORAX PRESSURE; VENOUS RETURN;

ANOXIA; CARDIOPULMONARY RESUSCITATION; DYSPNEA; HEART ARREST; HUMANS; RESPIRATION;

EID: 68049123054     PISSN: 10705295     EISSN: 15317072     Source Type: Journal    
DOI: 10.1097/MCC.0b013e3283298e00     Document Type: Review

References (27)

1. Bang A, Herlitz J, Martinell S. Interaction between emergency medical dispatcher and caller in suspected out-of-hospital cardiac arrest calls with focus on agonal breathing. A review of 100 tape recordings of true cardiac arrest cases. Resuscitation 2003; 56:25-34.
2. Eisenberg MS. Incidence and significance of gasping or agonal respirations in cardiac arrest patients. Curr Opin Crit Care 2006; 12:204-206.
3. Hauff SR, Rea TD, Culley LL, et al. Factors impeding dispatcher-assisted telephone cardiopulmonary resuscitation. Ann Emerg Med 2003; 42:731-737.
4. Rea TD. Agonal respirations during cardiac arrest. Curr Opin Crit Care 2005; 11:188-191.
5. Glossary on respiration and gas exchange. J Appl Physiol 1973; 34:549-558.
6. Lumsden T. Observations on the respiratory centres in the cat. J Physiol 1923; 57:153-160.
7. Clark JJ, Larsen MP, Culley LL, et al. Incidence of agonal respirations in sudden cardiac arrest. Ann Emerg Med 1992; 21:1464-1467.
8. Fung ML, Wang W, St John WM. Medullary loci critical for expression of gasping in adult rats. J Physiol 1994; 480:597-611.
9. Gozal D, Torres JE, Gozal YM, Nuckton TJ. Characterization and developmental aspects of anoxia-induced gasping in the rat. Biol Neonate 1996; 70:280-288.
10. St-John WM, Paton JF. Respiratory-modulated neuronal activities of the rostral medulla which may generate gasping. Respir Physiol Neurobiol 2003; 135:97-101.
11. St-John WM, Paton JF. Role of pontile mechanisms in the neurogenesis of eupnea. Respir Physiol Neurobiol 2004; 143:321-332.
12. Manole MD, Hickey RW. Preterminal gasping and effects on the cardiac function. Crit Care Med 2006; 34:S438-S441.
13. Yang L, Weil MH, Noc M, et al. Spontaneous gasping increases the ability to resuscitate during experimental cardiopulmonary resuscitation. Crit Care Med 1994; 22:879-883.
14. Sridhar R, Thach BT, Kelly DH, Henslee JA. Characterization of successful and failed autoresuscitation in human infants, including those dying of SIDS. Pediatr Pulmonol 2003; 36:113-122.
15. Noc M, Weil MH, Sun S, et al. Spontaneous gasping during cardiopulmonary resuscitation without mechanical ventilation. Am J Respir Crit Care Med 1994; 150:861-864.
16. Manole MD, Hickey RW, Momoi N, et al. Preterminal gasping during hypoxic cardiac arrest increases cardiac function in immature rats. Pediatr Res 2006; 60:174-179.
17. Xie J, Weil MH, Sun S, et al. Spontaneous gasping generates cardiac output during cardiac arrest. Crit Care Med 2004; 32:238-240.
18. Menegazzi JJ, Check BD. Spontaneous agonal respiration in a swine model of out-of-hospital cardiac arrest. Acad Emerg Med 1995; 2:1053-1056.
19. Noc M, Weil MH, Tang W, et al. Mechanical ventilation may not be essential for initial cardiopulmonary resuscitation. Chest 1995; 108:821-827.
20. Srinivasan V, Nadkarni VM, Yannopoulos D, et al. Spontaneous gasping decreases intracranial pressure and improves cerebral perfusion in a pig model of ventricular fibrillation. Resuscitation 2006; 69:329-334.
21. Ristagno G, Tang W, Sun S, Weil MH. Spontaneous gasping produces carotid blood flow during untreated cardiac arrest. Resuscitation 2007; 75:366-371.
22. Chandra NC, Gruben KG, Tsitlik JE, et al. Observations of ventilation during resuscitation in a canine model. Circulation 1994; 90:3070-3075.
23. Berg RA, Wilcoxson D, Hilwig RW, et al. The need for ventilatory support during bystander CPR. Ann Emerg Med 1995; 26:342-350.
24. Berg RA, Kern KB, Hilwig RW, Ewy GA. Assisted ventilation during 'bystander' CPR in a swine acute myocardial infarction model does not improve outcome. Circulation 1997; 96:4364-4371.
25. Berg RA, Kern KB, Hilwig RW, et al. Assisted ventilation does not improve outcome in a porcine model of single-rescuer bystander cardiopulmonary resuscitation. Circulation 1997; 95:1635-1641.
26. Bobrow BJ, Zuercher M, Ewy GA, et al. Gasping during cardiac arrest in humans is frequent and associated with improved survival. Circulation 2008; 118:2550-2554. This Arizona-based study provides recent human data on abnormal breathing patterns in cardiac arrest patients. The results confirm previous similar investigations and demonstrate that gasping is a common phenomenon early after the onset of cardiac arrest. The frequency of gasping decreases rapidly with increasing time of untreated ventricular fibrillation. The study confirms a positive association between the occurrence of gasping and favorable outcome.
27. Carter WB, Eisenberg MS, Hallstrom AP, Schaeffer S. Development and implementation of emergency CPR instruction via telephone. Ann Emerg Med 1984; 13:695-700.