Zachary Goldberger and colleagues1Goldberger ZD Chan PS Berg RA et al.for the American Heart Association Get With The Guidelines—Resuscitation (formerly the National Registry of Cardiopulmonary Resuscitation) InvestigatorsDuration of resuscitation efforts and survival after in-hospital cardiac arrest: an observational study.Lancet. 2012; 380: 1473-1481Summary Full Text Full Text PDF PubMed Scopus (300) Google Scholar report significantly improved survival by extending the duration of cardiopulmonary resuscitation (CPR). Although the relative benefit is 12%, the absolute benefit is only 1·9%. Most performers of CPR work with high levels of skill and judgment and without regard to specific time constraints. It is likely that the overall small benefits seen can be accounted for by accurate clinical judgments of the CPR teams. I declare that I have no conflicts of interest. Duration of resuscitation efforts and survival after in-hospital cardiac arrest: an observational studyDuration of resuscitation attempts varies between hospitals. Although we cannot define an optimum duration for resuscitation attempts on the basis of these observational data, our findings suggest that efforts to systematically increase the duration of resuscitation could improve survival in this high-risk population. Full-Text PDF Duration of resuscitation efforts and survival after in-hospital cardiac arrest – Authors' replyFu Shan Xue and colleagues express concern that longer resuscitation efforts did not significantly improve neurological outcomes and could simply prolong “inevitable death” in the highest-risk patients. We worry that they misunderstand key aspects of our study.1 First, the assertion that, in order for longer resuscitation efforts to be effective, they would have to improve neurological outcomes in those with longer resuscitations is erroneous. Indeed, we found that hospitals with longer efforts had similar neurological outcomes but higher survival rates than those with shorter efforts, suggesting a greater absolute number of patients surviving with favourable neurological outcomes in hospitals with longer efforts. Full-Text PDF