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Information from Your Family Doctor
Cardiopulmonary Resuscitation (CPR)
Am Fam Physician. 2000 Oct 1;62(7):1564.See related article on life-sustaining treatment.
When is CPR important?
CPR may be done when a person stops breathing or the heart stops beating (like when a person has a heart attack). When it's possible that the person may recover, CPR is important.
CPR is an option for a patient with an advanced life-threatening illness (like cancer) and who is dying. When the patient reaches the end of life, CPR may not be the option to choose. It's important for the patient, family members and doctor to talk about this issue before the need arises.
What is involved in the procedure?
During CPR, the chest is pressed on forcefully. Electric stimulation to the chest and special medicines are used. This is usually done for 15 to 30 minutes. A tube may also be put through the mouth or nose into the lung. This tube is then connected to a breathing machine.
What happens if CPR isn't done?
A person will become unconscious almost immediately and will die in 5 to 10 minutes.
What are the benefits of CPR?
For a patient with an advanced life-threatening illness who is dying, there are really no benefits.
CPR may prolong life for patients with a better health status or who are younger. CPR may also prolong life if it's done within 5 to 10 minutes of when the person's heart stopped beating or breathing stopped.
What are the risks of CPR?
Pressing on the chest can cause a sore chest, broken ribs or a collapsed lung. Patients with breathing tubes usually require medicine to keep them comfortable. Most patients who survive will need to be on a breathing machine in the intensive care unit to help their breathing for a while.
Few patients (less than 10 percent) in the hospital who have CPR done survive and are able to function the way they used to. Many patients live for a short time after CPR, but still die in the hospital.
Patients who have many illnesses usually don't survive. Almost no one with advanced cancer survives CPR and lives long enough to leave the hospital. Of the few patients who do, many continue to become weak or have brain damage. Some patients may need to live on a breathing machine for the rest of their life.
CPR may also prolong the dying process.
Information in this handout is from Education for Physicians on End-of-Life Care Trainer's Guide, Module 11, withholding, withdrawing therapy. In: Emanuel LL, von Gunten CJ, Ferris FD. Education for physicians on end-of-life care/Institute for Ethics at the American Medical Association. Chicago, IL: EPEC Project, The Robert Wood Johnson Foundation, 1999.
This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
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