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Norman Paradis, MD
Henry Ford Hospital Detroit, Mich

JAMA. 1990;263(24):3257-3258.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.—

Dr McNeill seems to have misunderstood a number of important aspects of our study. We did not recommend measurement of the aortic-to— right atrial gradient (Ao-RA) in cardiac arrest patients simply as a means to predict outcome, but as a guide to therapy and a standard for future research. We emphasized that measurement of this gradient may allow optimization of standard therapies and "provide a rational basis for use of" alternative, potentially more effective techniques.

The study was undertaken in a basic emergency medical services system specifically because of the minimal differential risk in these patients.¹ The absence of long-term survivors was expected in light of the study population. That "our sample does not represent the typical population of patients with cardiac arrest" is explicitly stated, as is a warning against applying these results to patients with short arrest times. Since the ramifications of these factors are . . . [Full Text PDF of this Article]

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