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Table 2 Case series claimed to document lack of autoresuscitation.

From: Donation after cardiocirculatory death: a call for a moratorium pending full public disclosure and fully informed consent

Study (year) n Selection criteria Monitoring > 2 min* AL Cont obs Author's conclusions Comment
Stroud et al (1947) [19] 23 "When practical, the electrodes were attached to the moribund patient before clinical death... tracings were taken intermittently or continuously until the string became motionless." Age 10-87 yr; 1 child age 10 yr. stated for n = 2 (adults) 0 not stated "Permanent standstill occurred without VF in 50% of cases." n = 2 not monitored at death, leaving a true n = 21.
Enselberg (1952) [20] 43 "EKGs were recorded for varying lengths of time before, during, and after death... resuscitative measures were applied in 22 cases." Age 8-80 yr; 2 children ages 8 yr and 14 yr. not stated 0 not stated "Recurring asystoles or ventricular standstills are common and often appear to be self-limited." "It is possible that in many cases the recording of terminal EKGs may have been stopped upon the appearance of a long asystole, before true cessation."
Robinson (1912) [21] 7 "EKG records obtained from 7 patients before and during the actual stoppage of the heart... There were naturally many failures to obtain records, especially when fatalities occurred suddenly." Age 9 mo-37 yr; 3 children ages 9 mo, 18 mo, and 4 yr. stated for n = 1 (age 9 mo) 0 not stated "Cardiac activity continued from 6-35 min after all the usual clinical signs of death had occurred." -Case 5 had resumption of cardiac rhythm at a rate of 33 bpm "after a stoppage of 2 1/2 minutes."
-Case 7 had no evidence of cardiac activity "17 min post mortem. Because the records were not satisfactory, a more detailed analysis is not possible."
Willius
(1924) [22]
6 "... six patients in whom almost continuous EKG records were obtained from 10 min to 7 hr 32 min preceding death." Age 29-58 yr (based on information for n = 4). not stated (4), several minutes (1), 1 min 3.04 sec(1). 0 not stated "The changes occurring in the mechanism of the human heart preceding and during death are variable..." -
Rodstein et al 1970 [23] 31 "A series of aged individuals in whom terminal EKGs and necropsies were available... Lead II was then continuously recorded until electrical activity ceased... The time of cessation of electrical activity- electrical death- was recorded. Where clinically indicated, the usual resuscitative measures were employed." Ages 73-101 yr. stated for n = 1. 0 not stated "The majority of deaths from all causes showed an EKG pattern of the dying heart..." In review of the literature they report "survival times after clinical death [of up to 50 min]." "In 7 (23%) of the 31 patients, electrical death terminated in VF... One patient terminated with a rapid VT."
TOTAL 110 Selection criteria poorly described. n = 5 n = 0 not stated variable terminal EKG patterns cannot determine if autoresuscitation occurs
  1. AL: arterial line; EKG: electrocardiogram; VF: ventricular fibrillation. Cont obs: continuous observation. *Monitoring > 2 min: refers to ongoing EKG monitoring for > 2 min after death was pronounced based on EKG asystole or VF. This Table is modified and reproduced with permission of the author, and was originally published in [37].