If return of spontaneous circulation (ROSC) does not occur after 30 minutes of advanced cardiac life support (ACLS) interventions including CPR, the patient will not likely recover even if the resuscitation time is extended. A retrospective review of in-hospital ACLS/CPR by Morris at the Children’s Hospital of Philadelphia showed that the average CPR time was 8 minutes with 70% of the patients having ROSC. Of these 70%, only about half survived to discharge. No patients receiving ACLS/CPR for longer than 30 minutes survived. Very few patients received ACLS/CPR for longer than 30 minutes, a reflection of AHA and PALS recommendations.
The problem remains that survival occurs in only about 1/3 of in-house ACLS/CPR patients. It is unknown how many patients would have succumbed to their underlying pathology if ACLS/CPR resuscitation was not a factor. However there is a great possibility that some of the deaths were attributable to reperfusion injury that occurred upon ROSC.
Perfusion Theory is an educational platform for the Oxygen Pressure Field Theory (OPFT). August Krogh’s theoretical concept of the oxygen pressure field is explained and then applied to clinical applications in perfusion practice.