Longer Resuscitation After Cardiac Arrest May Be Warranted, Study Suggests

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TUESDAY, Sept. 4 (HealthDay News) -- Longer resuscitation efforts improve the chances of survival in patients who suffer cardiac arrest in a hospital, new research contends.

The finding, published Sept. 4 in The Lancet, may be controversial, since it challenges the common belief that it's futile to extend resuscitation in patients who do not respond immediately, the study authors said.

However, study lead author Zachary Goldberger of the University of Washington said the new findings "suggest that prolonging resuscitation efforts by 10 or 15 minutes might improve outcomes."

Speaking in a Lancet news release, he added that extending resuscitation would not use up much more medical resources and have only "modest" effects on the patient's neurological health, should he or she survive.

In the study, Goldberger's team analyzed data from more than 64,000 patients at 435 U.S. hospitals who underwent resuscitation after suffering a cardiac arrest between 2000 and 2008. There was wide variation in the average duration of resuscitation attempts at the hospitals.

However, patients at hospitals where resuscitation efforts lasted the longest were more likely to be successfully revived (restoration of heart beat for at least 20 minutes) and to survive to be discharged from the hospital than patients at hospitals where resuscitation attempts were shortest.

The percentage of patients who survived to hospital discharge and had little or no brain damage was similar regardless of the length of resuscitation, the study found.

The researchers said their findings can't be used to define the ideal duration for resuscitation attempts, but do suggest that establishing minimum lengths of time for resuscitation may help improve outcomes in patients who suffer cardiac arrest in a hospital.

Currently, survival for these patients is low. Between one and five of every 1,000 hospitalized patients in developed countries suffer a cardiac arrest, and fewer than 20 percent of those patients survive to be discharged, according to journal background information.

Two specialists were cautious about the findings.

"It is difficult to draw definitive conclusions from this study," said Dr. Kenneth Ong, acting chair of the department of medicine and cardiology at The Brooklyn Hospital Center, in New York City.

"There are many variables that affect a person's survival after cardiac arrest," he said. "As the authors correctly point out, few guidelines exist to assist the resuscitation team, including the duration of the attempt. It is possible that those who survive and undergo the longest resuscitative efforts may have clinical features pointing toward success compared with those who may be judged medically futile by the caretakers and thus have a shorter period of resuscitation."

Another expert said the finding may not apply to most cardiac arrest patients.

"From clinical experience, overall survival after in-hospital cardiac arrest is quite poor when there is no clear reversible cause for the arrest," noted Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital, in New York City. "However, when there is a potentially reversible cause for the arrest, successful resuscitation efforts may potentially improve. This suggests that in these limited clinical situations, there may be a window of opportunity to improve care by increasing duration of resuscitation time prior to termination of efforts."

Glatter added, however, that the study "did not demonstrate that longer resuscitation efforts resulted in a higher percentage of patients who were neurologically intact upon discharge." He believes that there is no specific, ideal duration for resuscitation and decisions must be made on a case-by-case basis.

Also, Glatter noted, "this study was purely observational, and therefore cannot directly demonstrate a causal relationship between length of resuscitation and improvements in survival."

-- Robert Preidt Copyright © 2012 HealthDay. All rights reserved. SOURCES: Kenneth Ong, M.D., acting chair, Department of Medicine and Cardiology, The Brooklyn Hospital Center, New York City; Robert Glatter, M.D., emergency physician, Lenox Hill Hospital, New York City; The Lancet, news release, Sept. 4, 2012

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Anna Kendrick, 'What To Expect When You're Expecting' Star, Relieved To No Longer Be In 'Twilight'

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Normally, after I interview a celebrity, I somehow settle on the deluded notion that we could, one day, become best friends. This was not the case with Anna Kendrick.

Not to say that the star wasn't friendly, we just didn't "get" each other. Nevertheless, that didn't stop us from discussing her role in the upcoming big-screen adaptation of the consummate baby guide, "What To Expect When You're Expecting." Here, she plays Rosie, a colloquialism-spewing, food truck proprietor who ends up getting knocked up by her hunky pork-hawking competitor, played by "Gossip Girl's" Chase Crawford. (Swoon!)

Moviefone (awkwardly) chatted with Kendrick about phone grettings, baby bumps, and being relieved to no longer be a part of "Twilight."

Hi! How are you?
[Monotone voice] So good.

Good? Sorry?
Oh, yeah. So good.

“So good”... is that sarcasm? Are you doing tons of interviews?
[Laughs] No, I just say that. I guess I realized that’s my standard greeting when I actually do junkets and I say it to everyone. I go, ‘Oh, I say that a lot.’

Well, let's talk "What to Expect." How was it to shoot?
It was really fun, actually. We just got to shoot, mostly nights, in the warm Atlanta weather, on a food truck -- sometimes with a little baby bump, sometimes without. [It was] pretty great.

So you actually had a prosthetic baby bump?
I did. Because when I flash it and I’m not that far along yet, I kept saying, ‘Can’t I just like, have a big lunch?’ It’ll be great. It’ll be easier for everybody. And I want to have a big lunch. So everybody wins.

And I assume that didn’t happen?
Yeah, they still made me get the prosthetic, which took like three hours to put on and was incredibly uncomfortable. You know, it’s just like it’s hot and sticky and everybody wants to poke you -- all the time.

So you had a little taste of pregnancy, then. Do you have any baby aspirations of your own?
No, no. And everybody keeps asking me like, ‘Oh, did making the movie make you want to have babies?’ No, not at all. Like, wearing that prosthetic did not make me want to bring a life into this world.

Well, I imagine you read the book...
I haven’t read the book. That book scares me. It’s going to tell me all the crazy things that are going to happen to me when I have a kid and I don’t even want to know. I like being able to sleep at night.

Is there any book that you’d like to see be made into a movie?
Well, when I was a little bit younger, I read this book called “The Rapture of Canaan” and I thought that would make a cool movie, especially because there’s like a teenage girl lead part...if they made it now Hailee Steinfeld would be a great choice. But now I don’t even remember if the book was good. I was just like, ‘Aw, they should make this a movie so I can be in it.”

Your particular role was a more serious story than the others, was that by choice?
Well, I was going to play Jennifer [Lopez]’s part but I guess she wanted to do that... No, I was just f-cking with you.

Well, in “50/50” you played a serious part, too.
The script as a whole is kind of light and funny so I wasn’t really thinking about how serious my particular storyline was until we were filming and I was like, ‘Ugh, this is another bummer of a scene.’

Yeah. It was super sad. I kept thinking it was like being in a Ben Folds Five video or something.
[Laughs] Oh, my god. Yeah!

Is it weird for you to field all these pregnancy questions?
A little bit, yeah. I kind of knew that it would be coming but I feel like pregnancy and kids, it’s one of those things that once you talk about it, people always [recall that] like, ‘Oh, you said in 2012 that you are open to having kids’ and that like follows you around or something. And it’s one of those weird things where I’m trying to avoid sort of saying anything about it because for me, honestly, I haven’t really thought about it that much.

So you spent a lot of time on the food truck, were you actually working with food?
Yeah, they gave us cooking lessons, I chopped my fingernail off, which was maybe the single most painful experience of my life.

So, this isn’t sarcasm, then? That was real?
No. I chopped my fingernail off, like, half-way up my fingernail. Gone. Like, awful. And you don’t even end up seeing my slicing skills in the movie.

Oh, so there was a sequence where you were like, julienning something?
Yeah. And then they were like, well, actually, if we just shoot it this way, we won’t even see your hand... Yeah, lost a fingernail to the cause but, OK.

That’s awful. Have you ever been hurt on-set before?
Not really, no. I mean, I should have sued them or something, right?

You and Chace Crawford really seemed to get along.
Yeah. Everybody keeps asking us if we knew each other before but, yeah, we just met on set. He’s...obviously an incredibly handsome dude and I just kind of had to get past that little speed bump cause it’s hard for me to look somebody in the face when they’re that attractive.

How does it feel not to be involved in the final ‘Twilight’ movie?
It’s a relief, you know? Because it’s kind of off my shoulders [in terms of] talking about it. Because talking about it I always feel like I say something that gets misconstrued or I offend someone because people are so deeply passionate about that series. So, I’m actually sort of happy to be not talking about it.

"What To Expect When You're Expecting" hits theaters May 18.

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