Document Detail


Could we use abdominal compressions rather than chest compression in patients who arrest after cardiac surgery?
MedLine Citation:
PMID:  18948306     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether abdominal cardiopulmonary resuscitation (CPR) could be used instead of external cardiac massage either to protect the recent sternotomy or while chest compressions are not possible whilst a sternotomy is being performed. Altogether 386 papers were found using the reported search, of which 10 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Patients who arrest after cardiac surgery and require chest reopening will have a period of no external chest compression and therefore, no cerebral or coronary perfusion. In addition, if a patient arrests prior to cardiac surgery there will be a period of time performing the sternotomy during which there will be no external compressions. We found only one paper in a porcine model that looked at the effectiveness of abdominal only CPR although it did show that abdominal CPR was actually 60% better than chest CPR. Interposed abdominal and chest compressions has been much more extensively studied and has been shown to be significantly better in return of spontaneous circulation than chest compressions alone. We conclude that currently there is very little evidence to support abdominal only CPR although these studies may support the concept that it may potentially increase the coronary and cerebral perfusion pressure.
Authors:
Zulfiquar Adam; Safwaan Adam; Pia Khan; Joel Dunning
Related Documents :
9717016 - Prediction of behavioural and emotional problems in children and adolescents with opera...
16225716 - Unnecessary interruptions of cardiac massage during simulated cardiac arrests.
6533786 - The prognostic significance of dysrhythmias in the healthy elderly.
15951836 - Transgenic expression of the deoxynucleotide carrier causes mitochondrial damage that i...
19915846 - Peri-infarct dysfunction in post-myocardial infarction: assessment of 3-t tagged and la...
16200486 - Left atrial myxoma diagnosed and characterized by cardiac magnetic resonance imaging.
Publication Detail:
Type:  Journal Article; Review     Date:  2008-10-23
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  8     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-05     Completed Date:  2009-04-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  148-51     Citation Subset:  IM    
Affiliation:
Department of Cardiology, James Cook University Hospital, Middlesbrough, UK. adamz@doctors.org.uk
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Abdomen*
Animals
Benchmarking
Cardiac Surgical Procedures / adverse effects*
Cardiopulmonary Resuscitation / adverse effects,  methods*
Cerebrovascular Circulation
Coronary Circulation
Evidence-Based Medicine
Heart Arrest / etiology,  physiopathology,  therapy*
Heart Massage* / adverse effects
Humans
Reoperation
Sternum / surgery
Treatment Outcome
Comments/Corrections
Comment In:
Interact Cardiovasc Thorac Surg. 2009 Jan;8(1):151-2   [PMID:  19122161 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Worsened long-term outcomes and postoperative complications in octogenarians with lung cancer follow...
Next Document:  Early results of off-pump coronary artery bypass graft surgery using bilateral internal thoracic art...