1062
KAZUISTIKA425202011157120176236269319376408468532
/982202011133
CASE1040202011155117168223
REPORT1288202011157113168230289344
Uncommon4253230975296133177244312356402
presentation8443230974572113145186231258297324343388433
of12943230974468
gasping13793230974584116162181226272
during16683230974589116135180226
ventricular19113230973878123150177196233277297336362
fibrillation2290323097214288115135154173212239258303348
–265532309740
case27123230973675107148
report28773230972667113159186215
17417620201113676122
|343202011126
ANESTEZIOLOGIE4268043010753112155200245290342362425467527586607650
A10988043010753
INTENZIVNÍ1172804301071978123168227276296345405426
MEDICÍNA16198043010770114174195248268328382
/20468043010732
Anest21238043010753101145179208
intenziv235180430107186693136184221240281
Med.26528043010770114164180
2023;34(4):172-1752852804301074487128172186230275299341362377414451494519558595636
/35338043010731
www.aimjournal.cz48358043010765133201214257275349367415463490539579598614654693
artificial4256230107416798117141161201219260279
ventilation72062301074184132159178197237264283331380
and111662301074189139
when1271623010765114158206
to149462301072874
administer158562301074190164183230249282311353380
drugs198162301074976124173206
to220462301072874
suppress229562301073480130180207250284317
spontaneous26296230107338213118020724842576301074892141190223
ventilation67276301074084132159177196237264283331379
in107676301071866
case116676301074182115160
of135076301074872
apparently144676301074190140182208251299326345385
normal185676301074896123198238257
SpO2213776301074291153228882806326
during233776301074996123142190239
gasping.260076301074990123173192240289305
Gasping42590301075697131180199247296
is74490301071951
a818903010741
well-known882903010765108127146174213263311376425
phenomenon132990301075099143191239314358406454503
occurring185590301074789127175202229248296345
after22239030107416496138165
cardiac241090301074182108157175215256
arrest.26899030107416794137171200216
It425104301071947
is490104301071952
reported560104301072669119168195226269319
in897104301071966
33982104301074485
to1085104301072875
60%1178104301074489156
of1352104301074872
all144310430107405978
OHCA15391043010761118170224
patients1781104301075091118137181229256291
and2090104301074189138
is2247104301071851
common2316104301074087161235283332
during2666104301074996123142190239
the425118301072876120
first57111830107244470104133
minute731118301077392140187215258
in1015118301071967
patients1108118301075091119137181229256291
with1425118301076584112161
ventricular1612118301074184132159186205245293312352379
fibrillation201711830107234393120139158176217244263311359
[1–3].240311810109266911115617925811183010716
There2623118301074291136162205
is2854118301071952
ample4251323010741114164184228
literature67113230107193766108135176203251278321
on1010132301074897
the1125132301072876120
positive1264132301074999132150178197238281
relationship156413230107266989129156175223272305353371421
between2003132301075095122190233278326
the2348132301072876120
presence2486132301075077120154198246287329
of2834132301074771
gasping425146301074989122170189236285
and726146301074188137
the879146301072875119
probability1014146301074976122172213262281299317345387
of1417146301074871
successful1504146301073480120158200233266291339358
survival1878146301073379105149168208249268
without2162146301076583111159207254282
neurological2460146301074892139165211230278328346386426445
sequelae;425160301073376125172215234273317331
on772160301074795
the882160301072875118
other1016160301074874121165190
hand,1222160301074888135183198
there1436160301072775118144186
is1637160301071951
remarkably1704160301072668140180206244285334353392
little21121603010718366493112155
literature228316030107183664105131172198245271313
defining2612160301074891114133180198245293
gasping425174301074990124174193242291
and743174301074190139
its90917430107194783
difference101817430107496893120164191234283324367
from1411174301072452100174
eupnoea.1612174301074492142191240286326343
In1981174301071968
the2075174301072877122
available2223174301074282124142161202252272317
literature,256617430107203867110136178206254281324339
the425188301072878123
main5751883010775117136185
difference78718830107506994122167194238287329372
is1187188301071952
described1267188301074994129171198218268314366
as1660188301074176
a17631883010741
change1832188301074090131180231276
in2135188301071968
breathing2231188301075078122163191240260309359
pattern:2617188301075193121153196224274289
very425202301074184110153
rapid600202301072668117137186
inspiration807202301071967100149168195236263282330379
followed120720230107247191109158222266316
by1544202301075089
prolonged1655202301074976123143191240289333383
expiration.2060202301074383133152179220247266314363379
Ramirez2460202301074687161179206249286
and2767202301074189138
Lieske425216301074160105139177221
in673216301071967
their767216301072877122141168
publication962216301075099150170189230272299319367417
report1406216301072670121170198229
the1662216301072877122
absence1811216301074192126171220261304
of2142216301074873
expiratory2242216301074484135155182224252299326370
activity2639216301074183113133174194223266
and425230301074189138
lack583230301071959100138
of740230301074872
involvement832230301071967106153173214257331375423450
of1302230301074872
expiratory1393230301074483133153179221248294321364
muscles17772303010774121154195214258291
in2088230301071967
breathing2174230301075077120160187235254302351
pattern2544230301075092119149192218267
as2831230301074174
another425244301074189137165213257284
characteristic734244301074088128155196237267310336355388417436476
feature1235244301072467107135183209252
of1512244301074872
gasping1609244301074989123172191239288
[4].19222441010926699320142443010716
The2055244301074191135
transition221524430107285596145178196224243291339
between2579244301075095123190234278327
normal425258301074897124198239258
respiration702258301072770104153172198240267286334383
and1104258301074189139
gasping1262258301074990123172192239289
may15712583010773114153
not1744258301074896124
always1887258301074160125166205239
be2146258301074994
clear;2260258301074059103143170186
pre-gasping2466258301074976119148200240274323342390439
activity425272301074181112131172191219262
-7102723010726
the759272301072876121
transition90327230107275496144177195223242290339
between1265272301074994122190233278326
eupnoea1614272301074491141189238283323
and1960272301074189138
gasping2121272301074990123172191239289
similar2433272301073351125143162203229
to2685272301072874
our2782272301074896123
case425286301074082115159
except606286301074484123166215243
of871286301074872
high965286301074967116164
frequency115128630107245295145192236284325367
has1541286301074889122
also168528630107416093141
been1848286301075095140188
described2058286301074993127167194213263308358
[4].24382861010926699325302863010716
There2568286301074292136162205
are2796286301074067110
large42530030107195986134178
differences61930030107496791119162188231279319362395
concerning1031300301074086135175217244292311358408
effective145530030107446795138179209228269312
volume1783300301074188108155228272
of2072300301074771
gas2160300301074989122
exchange2299300301074383122170210258308351
during2667300301074996122141189238
gasping.425314301074990123172191239289305
Wolfskeil7543143010774120140164198236279298316
measured10953143010774118158192239265308358
tidal147831430107284696136155
volumes1658314301074188108155229273307
achieved1989314301074182130148192233276326
by2340314301074989
gasping2454314301074989123172191239288
and2767314301074189138
the425328301072876119
average561328301074180123149190239283
volume861328301074087107154227271
was11483283010765106139
about1303328301074190139187215
3501534328301074485128
ml1678328301077492
with1787328301076584111159
a19633283010740
wide2020328301076483132176
range2212328301072768116165209
of2437328301074871
52-12802525328301074485110148186228272
ml2813328301077493
[5].425342101092670955193423010716
Finally,559342301074260108149168186226238
scientific82234230107337493136185211230254274314
information116134230107196790138165239280307326374422
regarding1608342301072770120160187235254301351
the1984342301072776120
frequency212934230107235194144191235283324366
of2520342301074872
gasping2617342301074989123172191239288
is425356301071952
completely502356301074087161211230274302345364404
missing.932356301077392125158176224274290
Only12473563010761110129169
vague1442356301074082131179223
data1691356301074989116158
can1875356301074081129
be2030356301075095
found2151356301072371119167216
on2393356301074897
the2516356301072776120
mostly26623563010773122155184203243
slower425370301073452101165209235
frequency67837030107235194144191235283324366
of1062370301074872
agonal1151370301074190138187228247
breathing1415370301075077120160187235254302351
compared1783370301074087161210252278321371
to2172370301072874
normal2263370301074997124198239258
breathing,2538370301075077120160187236254302351367
which4253843010765114132172220
slows663384301073352100165199
down879384301074997162211
further110738430107247399130178222249
over1373384301074888131158
time1548384301072847120164
until1730384301074795122141160
it1907384301071947
spontaneously1971384301073483132181207249297341390438471490530
disappears2518384301074968100142192242287327353388
or425398301074875
reappears520398301072669109159209254294320354
when8943983010765114158206
chest1120398301074088132166195
compressions1335398301074086160210237280314347365413462495
are1849398301074168111
initiated.197939830107196786114132173200242292309
In565412301071965
this64541230107277491122
case782412301073979111154
report,951412301072667115162188218233
an1199412301074086
unusual1300412301074793139171216255273
rapid1588412301072666114132179
frequency178241230107235091139185228274313354
of2151412301074770
gasping2235412301074887119167185231279
(242529412301072364103
breaths2646412301074975116155181227259
per425426301075095121
minute)566426301077492140188216258280
was8654263010765107140
observed.1025426301074898131176202246289339355
In1400426301071967
our1487426301074896122
patient,1629426301075092119137181229256272
gasping1921426301074990123172192239289
with2230426301076584112160
unobstructed2410426301074896144194228257284332373403445495
airways42544030107415986154195234268
during710440301074996123142190239
CPR966440301075196140
had1123440301074989139
an1279440301074189
unquestionable1385440301074795145192236270299318366415455505525569
positive1971440301074998132150178197238281
effect226944030107446895139180210
on2496440301074897
maintaining26104403010773114133181207249267425454301074866114163
adequate604454301074190133183230270297339
oxygenation960454301074785127175219267307334353400448
(SpO214254543010723631121731595460806325
was16374543010765106139
100%1792454301074483128195
with2003454301076584112160
oxygen2179454301074785128176219267
flow246245430107244694158
826364543010744
l/min)2696454301071951122141188209
even425468301074485129178
without629468301076685114163212261289
artificial94546830107416899118143163204222263283
pulmonary1254468301075099118192242291332359402
ventilation1683468301074185134161180199240268287335384
(APV).2094468301072477123169197211
The2331468301074393138
duration2495468301075098124167194213262311
of2833468301074872
gasping425482301074990124174193242292
was7434823010766108141
prolonged911482301075077125145194243293337388
to1325482301072875
a14274823010741
full149548230107247392111
121633482301074482
minutes1742482301077493141189218261295
during2063482301075098124144192242
CPR2332482301075197141
until2500482301074897124143162
ROSC,26894823010745107148200216
partly425496301074989114144162201
also64149630107405889136
because792496301074993132172218250293
of1100496301074770
good1185496301074895142191
quality1391496301074894133151169196237
of1643496301074770
chest1728496301073986129161189
compressions,1932496301073984157204230272304336354400447479494
and2441496301074087135
probably2591496301074974120168209257275314
even425510301074484128176
several623510301073478119162188230249
minutes895510301077392140187215258292
after120951030107416596139165
ROSC.13975103010745106147198215
It1634510301071947
confirms1704510301074086135158178205279312
the2039510301072776120
previous2181510301075077120161180228276309
report2513510301072669119168195226
that2762510301072776116144
transition42552430107285597145179197226245293342
between794524301075095123191235280329
normal1149524301074998125200241260
respiration1436524301072670104153173199241269288336385
and1848524301074190139
gasping2014524301074990124173193241291
may23325243010774115154
not2513524301074897125
always2664524301074160126168207241
be425538301075095
clear544538301074059103143170
[4].738538101092669938305383010716
The870538301074292136
different103053830107496892119163189232280307
pressure1362538301074976119153186233260303
ratios168953830107276895114162196
in1909538301071967
the2000538301072876121
chest2145538301074088133166195
during2365538301074996122142190239
spontaneous2628538301073483132181208249425552301074892141190223
gasping666552301074990123172191239289
and973552301074189138
artificial113055230107406798117141160201219259278
ventilation1427552301074084132159177196237264283331379
with1825552301076584112160
intermitent200455230107186693136162236255283326374401
pressure2423552301075077120153187234260303
with2744552301076585113161
intermittent42556630107196794136163237255284314357405432
pressure875566301074976119153186233260303
should1196566301073381130178197246
also146056630107416092141
be1619566301075095
taken1732566301072769107150198
into194856630107196794140
account.2106566301074182121167215264290307
The2431566301074291136
literature258556630107193765108134176203251277320
comparing,425580301074188163213256283302351401417
for869580301072472100
example,996580301074484126201251271316331
active1354580301074182113133174218
compression-decompression159958030107418816321424128531935337242147049955159563768576081083888191695096810171067
resuscitation269258030107277110515318742559430107405987129156175223272
and723594301074189139
impedance888594301071993142187238279327367410
threshold1324594301072877103146180228277296346
device1696594301074993134154194237
for195959430107247299
out-of-hospital2084594301074896125149200224249299347381430450478519539
cardiac2649594301074082108157175216256
arrest42560830107406692134167196
does636608301074996140173
not824608301074895122
give962608301074866106149
clear1126608301074058101140166
results1308608301072668101147165192226
either155060830107436189136179205
[2].17716081010925709318626083010715
Thus,1893608301074190137169184
our2093608301074794120
decision2229608301074891132149181199246294
was25386083010765105137
based2691608301074990122166215
primarily42562230107497695168208234253271311
on752622301074896
the864622301072876119
clinical100062230107405876124142182223241
condition1258622301074086134183201229247295343
of1617622301074871
the1705622301072775119
patient.1840622301075091117136179227253270
Because2126622301074589130171218250294
of2436622301074872
apparently2524622301074190139180206249296323342381
good425636301074997146196
effect64463630107446895139180210
of877636301074872
gasping972636301074989123172191239288
on1283636301074897
oxygenation1403636301074886129177221269310337356404453
we18796363010765108
decided2010636301074993134153202246296
not2329636301074897124
to2476636301072874
start2573636301073463104131162
30:22758636301074387103148
compression-to-ventilation4256503010741891652162442893233583774264775065355836136567007507787988178598879079561006
ratio145965030107277098118167
recommended1654650301072771114162238314359409460505557
in2238650301072069
ERC2334650301074389143
guidelines.2504650301075099119169215235254303349384401
The425664301074292136
reason584664301072669109143191240
for84766430107237198
this96866430107287694127
decision1118664301074993134153185204252300
were14416643010765109135178
published1642664301075098148167186218266310360
data2025664301074990117159
mainly22066643010774115134181200240
from246966430107245299173
animal2665664301074189107181221240
experiments,425678301074485136182210230305350399427463479
that931678301072978120148
compared1106678301074189164215258285329380
to1513678301072976
APV1617678301075399147
gasping1791678301075092126176196245296
has2114678301074991125
several2266678301073479121165193235255
beneficial2548678301075197146191216236278297338358
effects42569230107446795138179210245
on687692301074896
circulation80169230107405885124171190231258277325373
and1192692301074189138
brain1347692301075077119137185
functions.1549692301072473121161192210258307340357
Gasping1923692301075697131180199247296
produces2237692301074976123173221261304338
negative2592692301074892142183210229270313
intrathoracic42570630107196692118159185233280307348387406445
pressure886706301074975118151183229255297
and1199706301074188136
generates1351706301074992139183209250276318351
a17187063010740
pressure1774706301074975118151183229255297
gradient2087706301074974115164182225272299
between2401706301075094121187230274321
right273870630107274594141167
heart425720301074892133159190
and632720301074189139
large78872030107196086134178
vessels984720301074184117151195214247
that1248720301072876117144
promotes1410720301074976123197246273316349
venous1777720301074184132180229261
return.205672030107266997145172220237
Minor2310720301077089137186212
increasing2540720301071967107134177217250268316365
of425734301074873
intrathoracic52573430107196794122164191240289317359400419460
pressure1012734301075077121155189237263307
during1346734301074997124144192242
expiratory1615734301074485135155182224251299326370
phase20117343010751100141175220
potentiates22587343010750100127171219247266307334377412
aortic2696734301074291118150169210
pressure.425748301075077120153187234260303318
Gasping-induced767748301075697130180199247296324344392441489529572622
changes1413748301074088128176226270304
in1741748301071866
circulation183174830107405985124172191231259277325374
improves2229748301071992142169216256299333
coronary2586748301074086113161209250276319
perfusion,425762301075095121148197230248296345360
but804762301075099127
also95076230107416092141
brain1110762301075077118137185
circulation.131476230107405985124172191231258277325374390
Similar1723762301074260134152171211238
changes1980762301074088129177226270304
can2303762301074082130
be2452762301075095
observed2566762301074898132176202246289339
in425776301071966
humans508776301074895169209257290
using81477630107488199147196
active1026776301074182112130171214
compression-active1257776301074086160209236279313346364412460488529569599618659702
decompression1975776301074993134180254304331373407440458506554
device2546776301074993133152193235
[6].27987761010925709428907763010716
Moreover,3047623010770119147190239280323350362
strenuous34356230107346390134182230279327360
gasping382262301074990124173193241291
would4139623010766114162181231
interfere43966230107196895137164191235262305
with472862301076584113161
APV491662301075398145
and508762301074190139
general525362301074994142187213255274
anaesthesia304776301074189130174207236285329363381421
would3488763010765112161180229
be373676301075095
necessary.385176301074892133176210243285311354366
The318790301074292136
question334090301074997141175204222270319
remains367790301072669143184202250283
as397890301074174
to407090301072774
whether4162903010765113157185233278304
gasping448490301074989123172191239288
can479090301074082130
be493790301075095
used505090301074780125175
in524290301071967
some532790301073382156200
cases3047104301074183117161196
as3270104301074175
the3372104301072877122
only3520104301074998118158
ventilation3705104301074185134161181200241269288337386
during4118104301074998124144193243
chest4388104301074089134168198
compression4612104301074188163214241285319353372420470
without5109104301076585114163212261289
following5425104301072472304711830107193785149168215264
the3327118301072775119
standard3462118301073362103150199239265313
30:23791118301074386102146
compression-to-ventilation3953118301074086159208235277310343361408456484512558587627670717744762781821847866913961
ratio493111830107266794112160
recommendation51071183010726681091552283013453923047132301074888114133180227
(so-called3290132301072355102131172213231249292341
“hands3647132301072673112160208240
only3903132301074795113152
CPR”).4071132301075094137164190202
We42891323010773114
found4418132301072470117164213
only4647132301074794113152
three4815132301072774100142186
similar5016132301073351123141159199224
reports.5256132301072668117165191221255271
Bunya3047146301074593141179221
et3284146301074471
al.337214630107415975
described3464146301074992126166193212261306356
a38361463010741
successful3894146301073380120159201235268293341360
resuscitation4271146301072669102149182222241269310337356404452
of4739146301074872
a48281463010740
man48851463010773114162
with5063146301076584112160
asystole5240146301074174115148177224243287
but3047160301074997125
with3188160301076483111158
preserved3362160301074976118151195221264307356
breathing3734160301075076118158185232250298346
(no4096160301072469117
other4229160301074774122165191
data4436160301074989116156
concerning4609160301073985133173215241289307355403
ventilation5028160301074183131157176194234261279326374
are5418160301074167109
available)3047174301074079120138156195244263306326
[7].33891741010925719734851743010715
In3516174301071966
their3597174301072875118136162
second3774174301073377117162210258
publication,4048174301074996144163181220261287305352400415
they4478174301072875118157
mentioned46511743010772115163189207254301344393
a50601743010740
transport511617430107275394141173221269295326
of5457174301074771
patients3047188301075091118137181229256291
after335718830107416496138165
OHCA35401883010761118170224
with3783188301076584112160
continuous3962188301074087135162181229276325373406
chest4387188301074088132166195
compression4600188301074187161211238281314348366414463
and5081188301074189139
gasping5239188301074989123172191239288
only3047202301074795113152
to3215202301072772
a33032023010740
hospital3359202301074795127175194221261280
with3654202301076483110157
good3827202301074895143192
survival4034202301073479105148167207247265
rate,431520230107266793134148
but4479202301074996123
again4618202301074088128146193
without4826202301076483110157204252279
more51202023010773120147188
detailed53242023010748911181591763047216301071963112
information317621630107196690137164238278305324371420
concerning3612216301074086135175217244292311358407
agonal4036216301074089137186226245
breathing.4297216301075077119159186234253300349365
[8]467921610109257094
An47892163010752100
extreme4906216301074383113140183256300
duration5222216301074996122164191209257305
of3047230301074872
gasping3140230301074989123172191239288
–34492303010745
673515230301074485
minutes3621230301077493141188216259292
–39342303010745
in4000230301071967
a40882303010741
patient4149230301075092119138181230256
with4426230301076585113161
ventricular4608230301074084132159185205245293312352378
fibrillation500723030107244493120139158177217244263311360
was53882303010765106139
reported3047244301072770120170198229272323
by3396244301075190
Okamoto35132443010761101143218267295342
et3881244301074473
al.398024430107426177
[9].40842441010926709541772443010716
Gasping4220244301075698132182201250300
was45462443010766108142
preserved4714244301075078121155200227272315366
all510724430107416079
the5213244301072877122
time5361244301072847122166
during3047258301075099126146195245
transport,332025830107285698148182232282310342359
repeated3706258301072771122168209237281332
defibrillation4066258301075095119140190218238258277319346366415465
and4558258301074291142
connecting4727258301074189139188233276307326375426
to5180258301072976
ECMO.5284258301074295167229243
Patient3047272301074585112131175223250
survived.3317272301073379105148166206249298313
The3649272301074290134
second3801272301073477118163211259
patient4079272301075090117135177225251
of4348272301074871
Okamato4438272301076098140212252278324
et4781272301074370
al.487027230107415974
was49622723010765106138
also511927230107415990138
treated527527230107285496135162203252
by3047286301075088
ECMO3159286301074292161221
and3403286301074188137
had3563286301074888137
preserved3723286301075076118151194220263305354
gasping,4101286301074988121169187234283298
but4422286301075097124
no4570286301074896
information468928630107196688135161235274301319366413
concerning5126286301074086133173215240288306353401
its304730030107194680
duration3143300301074996121162188206253301
was34603003010765105138
described.3614300301074992125165190209257301350366
Here39963003010757100125168
we41803003010765107
come4303300301074186160203
to4522300301072874
the4612300301072875118
next4746300301074992131161
question,4923300301074895138171199217264312327
namely5266300301074888160204222261
whether30473143010765113156183230274299
we33683143010765107
should3497314301073481128176194242
perform3761314301074993119145192218291
early4074314301074383108127166
advanced4262314301074189129170217257298347
airway463131430107415984151192230
management48823143010774114161201249293365409456482
(e.g.538631430107246478126141
tracheal304732830107275392131177220258275
intubation333632830107196590136184223249266312359
and3709328301074086134
artificial385732830107406594112134152191208246264
lung4135328301071864110157
ventilation)4306328301074182128153171188227252269315362382
or4702328301074773
prefer4789328301074974115137179204
gasping5007328301074887118166183229277
during5298328301074893118136182229
extended3047342301074483112154201250293342
CPR3406342301075195138
in3561342301071865
patients3643342301075090117135177225251285
with3944342301076583111158
gasping.4119342301074988121169187234283298
The4434342301074190134
differences458434230107496790116159185227274314355388
in4989342301071865
available5071342301074180120138156196244263306
literature539434230107193663105304735630107266793140165207
and3269356301074187136
lack341935630107195998135
of3569356301074871
sufficient3654356301073480103129148187204247294320
data3989356301074888114154
does4158356301074996140172
not4345356301074896122
allow448235630107405876123186
us4683356301074880
to4777356301072874
give4865356301074967107149
a50293563010740
clear5084356301074058101140165
answer.5264356301074087119184226252263
On30473703010760108
the3172370301072775118
one3306370301074896139
hand,3461370301074888135184198
there3676370301072775118144186
are3878370301074166108
data4002370301074989115156
from417437030107235096169
animal4360370301074088105178218236
studies4612370301073361108157175218250
of4879370301074771
beneficial4966370301074993141184207226265283322340
effect532237030107446793136176205
of3047384301074871
gasping3133384301074989121169188235283
on3431384301074896
brain3542384301074975116134181
circulation373838430107405883121168186226252270317365
and4118384301074088136
cardiac4269384301074081106153171211250
output4534384301074895123172219246
compared4795384301074086159208249274316365
to5175384301072874
APV5264384301075297142
[6].54213841010926699355123843010716
On30473983010759106
the3167398301072773116
other3296398301074773119161186
hand,3496398301074786132179193
artificial370339830107406594111133151189206245262
pulmonary3979398301074995112183229276314339380
ventilation4373398301074081127152169186225250267313360
eliminates474639830107436178149166211250275316348
the5107398301072874116
patient’s5237398301074988114131173219244261290
breathing3047412301075076119159185233251298347
effort341941230107446794141168198
and3642412301074189138
may38054123010774114153
reduce3983412301072669119166206248
lactic425641230107195999129147187
acidosis446841230107418199148196229246278
in4771412301071967
tissues.486241230107284779112158202235251
The5138412301074292135
results5298412301072770103149168195229
of3047426301074872
the3144426301072876120
acid-base328942630107418199148176226267300344
balance3658426301075092110150198238281
examination3964426301074483124198216263304330349396445
indicated4434426301071966116134174215241284333
that4792426301072977117144
the4961426301072876120
body5106426301075099148188
made53194263010775115165208
a30474403010741
maximal31044403010774114153171243283301
effort342144030107446793140166196
to3633440301072874
compensate3723440301074086159208252299331372398440
for417944030107247096
metabolic42924403010773117144184233281300317357
acidosis466544030107418098146194226244275
by4957440301074988
hyperventilation,5061440301074886136180205248290338364382399439304745430107284693141155
suggesting3224454301073379128176219252280298345394
that3639454301072875115141
the3802454301072875118
patient3942454301075090117135177225251
had4214454301074888137
a43724543010741
preserved4435454301074975117150194219262304354
respiratory4810454301072769102150168194234261306332374
response5206454301072769101150198246278321
to3047468301072874
the3138468301072875118
low3274468301071966130
pH34214683010750106
even3544468301074484126173
during3735468301074995121139186235
cardiac3987468301074081106153171210250
arrest425446830107416793135168196
and4467468301074188137
resuscitation.4621468301072769101148180219237264305331349396444459
We50974683010774115
can5229468301074081128
only5374468301074896114153
speculate3047482301073482127168215233273300342
whether34134823010766114158185233276302
elimination374048230107446280153171218258285303351399
of4163482301074972
oxygen4260482301074885128176219267
consumption4552482301074086134167213286335362380428476
using505348230107488098145194
muscle52724823010774121153193212255
relaxation304749630107266886125163203229246293340
would34014963010764111157175223
have3638496301074887125167
led3819496301071962110
to3943496301072873
a40304963010741
better4085496301074993119148189215
outcome.4314496301074794121158203275318332
Next46604963010757100138167
benefit4841496301075093140182205223250
of5105496301074870
the5190496301072774117
use5321496301074779122
of5457496301074770
general3047510301074890136178202242259
anaesthesia3319510301074086125167198225271313345361399
with3732510301076481107153
advanced3899510301074087126165211249289337
airway425051030107405781146185222
strategy448651030107336084124149189237275
is4775510301071849
our4837510301074793118
concern4968510301074084130169209233280
that5262510301072773111136
the5412510301072773115
patient3047524301075090117135177225251
might3316524301077492140187213
perceive3547524301075094120158199217257300
subjectively3865524301073480128147190230259277317360378417
unpleasant4301524301074895143162205244277318365391
and4710524301074188137
painful4865524301075091108155178226244
procedures5127524301075076122163204253300325367400
during3047538301074996121139186235
CPR3299538301075195138
(mainly3455538301072494134151198217256
chest3728538301074087130163191
compressions3937538301074085159207233275308341358405453485
and4439538301074188137
defibrillation)4593538301074992115134182208227245262302328346393441462
as5072538301074173
well51625383010765108126144
as5323538301074173
risk541453830107264576113
of3047552301074871
regurgitation3143552301072769119166191239257284325351369417465
and3633552301074188137
aspiration.3795552301074173122141166207234252299347363
On41825523010761109
the4316552301072876119
other4460552301074875122166192
hand,4676552301074989136185200
cardio-depressive4901552301074081107154172219248299342391418460493526543584626
effect304756630107436692135175204
of3266566301074770
anaesthetics3351566301074087127170202230277320347365404437
and3803566301074188136
muscle39535663010774120152191209252
relaxants422056630107266886125164204251277310
and4545566301074187136
well-known46955663010765107126143170208256303367415
risk512456630107274576113
of5252566301074770
failed53375663010723648299142191
tracheal304758030107285494134181224264282
intubation335358030107196692139188228254272319367
may37455803010773113151
result3920580301072769102148166193
in4137580301071966
unfavourable4228580301074795117158197244291316357406425468
result4720580301072769101148166193
[10].493758010109266810913350685803010716
Surprisingly,5108580301074288114163189207239257304352370409420
even3047594301074483126173
large-scale323659430107195985132175203236276316334377
studies3630594301073362109157175218251
do3897594301074996
not4010594301074895122
give4148594301074967107149
a43145943010741
clear4371594301074058101140166
answer.4553594301074188120185228254265
The4834594301074291134
latest498559430107195885126159187
European5189594301074187112158207252291338
Resuscitation3047608301074691125172205246265293335362381429478
Council3551608301075299148197238256275
guidelines3851608301075098117166211230248297341375
stated4252608301073463105132175225
that:4503608301072877118145162
“Advanced4690608301072775124166207256297340390
life510660830107193862105
support5237608301073482132182232259290
providers3047622301075076122161180228271297330
should3400622301073380128175193241
initiate366462230107196683110128168194236
artificial392262230107416797114138156196214253271
ventilation4216622301074083130156174191231257275322370
as4609622301074173
soon4705622301073381129176
as4904622301074173
possible5000622301075098130163180229247291
in5313622301071966
any5402622301074088125
patient3047636301075090117135177225251
in3315636301071966
whom33996363010765112160233
spontaneous3650636301073382130178204244291335383430462
ventilation4130636301074083130156174192231257275322370
is4518636301071950
inadequate4586636301071966106154197246293333359401
or5004636301074874
absent”5096636301074189122165213239268
[10].538163610109266810913355126363010716
Does30476503010758106150183
this324665030107287593125
mean33866503010774117157204
that3606650301072775115141
in3763650301071865
some3844650301073481155198
cases4058650301074080113156189
of4263650301074871
gasping4350650301074988121169187234283
with4649650301076583110157
apparently4822650301074190139180205247294320339378
large521665030107195884131174
gas5406650301074989121
exchange3047664301074484124172213261311355
volumes3427664301074289109157231275309
and3761664301074290140
high3926664301074968117165
rates,411766430107276996138172188
where43306643010766115160186229
patients’4584664301075193120138182231257292308
respiratory4917664301072770104154172199240267314341384
effort532766430107446895143170201
prevents3047678301074975117156198245270304
manual33656783010773113160206245263
face3642678301072464104145
and3801678301074188136
bag3951678301074990138
breathing,4103678301075075117156181228246292340355
oxygen4472678301074885126173216263
administration4749678301074189161178225242273301327367393410457504
alone5268678301074058105152195
is5477678301071950
sufficient?3047692301073378101126145183200242288313344
In3404692301071965
our3483692301074793118
opinion,3615692301074795113159176222269283
it3911692301071945
is3970692301071950
necessary4034692301074789129169201233273298339
to4387692301072772
proceed4472692301074975120159200243291
individually4777692301071864111129168186233278317334351390
in5181692301071864
atypical5259692301074066106155173211251268
situations304770630107345178125165191209256304336
using340170630107488097144193
all361170630107415977
clinical370670630107405876123140180220238
knowledge.3962706301073887134198217260309358401415
Conclusion30477307015377143216273313385438479544617
In3047748301071966
this312974830107277593125
case3270748301073980113156
report,3442748301072668117165191222237
we36957483010765107
described3818748301074992125165190209258302351
an4185748301074088
abnormal4288748301074189137185211284324343
agonal4647748301074089136184224242
breathing4905748301074975117157183231249296344
pattern5265748301074990117146188214262
during3047762301074996123142190239
CPR3307762301075196140
in3468762301071967
a35557623010741
patient3617762301074991118137181229256
with3894762301076584112160
ventricular4075762301074084132159185205245293312352378
fibrillation447476230107244493120139158177217244263311360
and4854762301074189139
demonstrated5013762301074993167216264297326353395422464514
that3047776301072877118145
in3219776301071967
some3312776301073483158202
cases3541776301074082115160194
gasping3762776301074990123173193241291
may40797763010774115154
be4260776301075095
effective438277630107446895139181211230272315
as4724776301074175
a48257763010741
single4893776301073452100150169213
method51337763010774119147196244295
of5454776301074973