A system employing an ECG monitor (40) and a defibrillation advisory controller (20). In operation, the ECG monitor (40) monitors a cardiac rhythm of a patient, and the defibrillation advisory controller (20) generates a defibrillation advisory based on a cardiac rhythm status and a metabolic cardiac status of the patient, and optionally further based on an electrical cardiac status of the patient. The controller (20) derives the cardiac rhythm status as monitored by ECG monitor (40), and the optional electrical cardiac status inclusive of the cardiac rhythm monitored by the ECG monitor (40), and derives the metabolic cardiac status exclusive of the cardiac rhythm monitored by the ECG monitor (40). The controller (20) may compute or receive metabolic cardiac data indicative of the metabolic cardiac status (e.g., incorporating or coupled to a user input device (50), a breath analyzer (60) and a blood analyzer (70)), and compares the metabolic cardiac data to a metabolic cardiac threshold (fixed or variable) and/or monitors a trend of the metabolic cardiac data to derive the metabolic cardiac status of the patient.
