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[Limits of resuscitation. I. Thanatophysiologic and therapeutic limits]
Abstract:
Neither apodictic demands nor administration measures are suited to satisfy the various problems of the duty of treatment in the borderline region between life and death. An exact knowledge of the thanatophysiologic limits of the possibility of resuscitation during and after an anoxia and ischaemia is necessary. By effective cardiopulmonary measures of resuscitation, such as external heart massage with production of systolic pressure of 8-13 kPa as well as respiration with F1O2 1.0, the cardiac resuscitation time with immediate sufficiency (1. limit 4-41/2 min) may be prolonged to the cerebral resuscitation time from 8-10 minutes. Probably, the new concept of specific measures of cerebral resuscitation may definitively prolong also this 2nd limit. Furthermore, the fundamentals of the decision are discussed, for omitting or finishing a reanimation, or for reducing the intensive treatment. If the clinical syndrome of the dissociated cerebral death is present, without planned taking off an organ there is no necessity to render the finish of the intensive therapy dependent on legal regulations concerning the performance of organ transplantations.