{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T06:03:04Z","timestamp":1790056984997,"version":"4.0.1"},"reference-count":13,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,2,20]],"date-time":"2019-02-20T00:00:00Z","timestamp":1550620800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acute Medicine &amp; Surgery"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Agonal respiration following out\u2010of\u2010hospital cardiac arrest is associated with favorable neurological outcomes. Resuscitation using extracorporeal membrane oxygenation could contribute to achieving favorable neurological outcomes in patients with refractory cardiac arrest.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>We report two cases of refractory cardiac arrest with non\u2010shockable rhythms and agonal respiration; both patients were successfully resuscitated through extracorporeal cardiopulmonary resuscitation (ECPR). Both patients were breathing spontaneously upon arrival. One patient was asystolic and the other experienced pulseless electrical activity followed by ventricular fibrillation. Agonal respiration was observed in both and ECPR was implemented, leading to a favorable neurological outcome at discharge.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The presence of agonal respiration has the potential to confer a favorable neurological outcome in patients with refractory cardiac arrest if maintained, even when the initial cardiac rhythm is not shockable. In these cases, resuscitation should not be abandoned, and ECPR should be considered.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ams2.398","type":"journal-article","created":{"date-parts":[[2019,2,21]],"date-time":"2019-02-21T07:45:13Z","timestamp":1550735113000},"page":"197-200","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["The prognostic value of agonal respiration in refractory cardiac arrest: a case series of non\u2010shockable cardiac arrest successfully resuscitated through extracorporeal cardiopulmonary resuscitation"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3605-402X","authenticated-orcid":false,"given":"Naofumi","family":"Bunya","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Sapporo Medical University Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5595-9054","authenticated-orcid":false,"given":"Kenshiro","family":"Wada","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Sapporo Medical University Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayumu","family":"Yamaoka","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Sapporo Medical University Sapporo Japan"},{"name":"Department of Neurosurgery Sapporo Medical University Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6914-506X","authenticated-orcid":false,"given":"Ryuichiro","family":"Kakizaki","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Sapporo Medical University Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoichi","family":"Katayama","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Sapporo Medical University Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takehiko","family":"Kasai","sequence":"additional","affiliation":[{"name":"Emergency Department Hakodate Municipal Hospital Hakodate Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryoko","family":"Kyan","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Sapporo Medical University Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoto","family":"Murakami","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Renal and Metabolic Medicine Sapporo Medical University Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuaki","family":"Kokubu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Renal and Metabolic Medicine Sapporo Medical University Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuji","family":"Uemura","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Sapporo Medical University Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eichi","family":"Narimatsu","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Sapporo Medical University Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,2,20]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.799940"},{"key":"e_1_2_6_3_1","first-page":"351635","article-title":"Gasping in response to basic resuscitation efforts: observation in a Swine model of cardiac arrest","volume":"2010","author":"Zuercher M","year":"2010","journal-title":"Crit. 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