Document Detail


Energy dose and other variables possibly affecting ventricular defibrillation during cardiac surgery.
MedLine Citation:
PMID:  6465560     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Previous studies have suggested that shocks of 5-10 J are required for direct ventricular defibrillation during open heart surgery. However, the efficacy of shocks of less than 5 J, the effects of thermal, biochemical, and temporal factors, and the influence of disease process on defibrillation have not been fully investigated, particularly with modern techniques of myocardial preservation. The purpose of this prospective study in 150 adult cardiac surgical patients was to evaluate the energy, current, and myocardial resistance with low energy DC shocks of 1, 2.5, and 5 J and to relate which biochemical, temporal, thermal, or other factors influence the outcome of a DC shock. Twenty-eight percent of shocks of 1 J and 55% of shocks of 2.5 J produced defibrillation. Above 2.5 J, the success rate reached a plateau at 55%. Other factors associated with the success of DC shocks were high normal serum potassium levels, high PaO2, high ionized calcium levels, and longer reperfusion times at mean arterial and coronary perfusion pressures above 50 mm Hg. Disease process may also play a role because patients with valvular heart disease were more difficult to defibrillate. Heart weight and thickness of ventricular myocardium, measured angiographically, appeared less important in direct defibrillation, except with 1 J shocks when thinner-walled ventricles defibrillated more easily.
Authors:
C L Lake; T D Sellers; S P Nolan; I K Crosby; H A Wellons; R S Crampton
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  63     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  1984 Aug 
Date Detail:
Created Date:  1984-08-29     Completed Date:  1984-08-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  743-51     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Blood Chemical Analysis
Cardiac Surgical Procedures*
Coronary Disease / physiopathology
Electric Countershock / methods*
Heart
Heart Valve Diseases / physiopathology
Heart Ventricles / anatomy & histology
Hemodynamics
Humans
Intraoperative Period
Organ Size
Prospective Studies
Random Allocation
Temperature
Time Factors
Grant Support
ID/Acronym/Agency:
25919NHLBI/HL/NHLBI NIH HHS

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


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