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June 6, 2011

Minn. man survives 96 minutes without heartbeat thanks to capnograph

Chicago Daily Herald

CHICAGO — A little-known device is shaking conventional wisdom for reviving people who suffer sudden cardiac arrest: People may be able to go much longer without a pulse than the 20 minutes previously believed.

The capnograph, which measures carbon dioxide being expelled from the mouth of the patient, can tell rescuers when further efforts at cardiopulmonary resuscitation, or CPR, are futile or whether they should be continued. It is the latest effort that cardiology experts and emergency teams are devising that aim to improve a patient’s odds.

For Howard Snitzer, a 54-year-old chef from Goodhue, Minn., a capnograph kept his rescuers from giving up. When Mr. Snitzer collapsed from cardiac arrest outside a grocery store, two men at a gas station across the street sprinted to his aid.

His rescuers, who rotated every couple of minutes to avoid fatigue, kept pumping his chest. Thirty-four minutes after he went down, a medical team from the Mayo Clinic swooped in via helicopter. During the ordeal, 11 shocks with a defibrillator failed to restore his heartbeat.

What kept them going? Readings displayed on the capnograph brought by the Mayo team indicated the air coming out of Mr. Snitzer’s lungs had healthy levels of carbon dioxide — strong evidence that CPR was effectively moving oxygenated blood to his brain and other organs. A person who is down for 10 to 12 minutes without any assistance is almost impossible to revive.

Other organs such as the kidneys and the lungs "can tolerate longer periods" without oxygen, but the brain is the organ that succumbs most likely early on, says Roger White, a Mayo Clinic anesthesiologist involved in Mr. Snitzer’s case and an expert in management of sudden cardiac arrest.

Mr. Snitzer "experienced a complete neurological recovery" and White described the episode as the "longest duration of pulselessness in an out-of-hospital cardiac arrest with a good outcome."

Copyright 2011 Paddock Publications, Inc.

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