Document Detail


Is internal massage superior to external massage for patients suffering a cardiac arrest after cardiac surgery?
MedLine Citation:
PMID:  18000024     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 open chest cardiac massage is superior to closed chest compressions in patients suffering cardiac arrest following cardiac surgery. Using the reported search, 527 papers were identified. Fifteen papers represented the best evidence on the subject and the author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results and study comments and weaknesses were tabulated. The quality and level of evidence was assessed using the International Liaison Committee on Resuscitation guideline recommendations. We conclude that over 18 good quality animal studies have consistently demonstrated the superiority of open chest cardiac massage, with the cardiac index and coronary perfusion pressures often more than doubling. There are fewer human studies but they have shown that closed chest massage generates a cardiac index of around 0.6 l/min/m(2) which rises to 1.3 l/min/m(2) or more with open-chest-CPR, accompanied by even bigger improvements in coronary perfusion pressure. ILCOR recommends prompt conversion to open-chest-cardiac massage in patient's shortly post-cardiac surgery, and we would support this intervention if simple resuscitative efforts such as defibrillation, pacing or atropine fail, in order to significantly improve the quality of cardiopulmonary resuscitation.
Authors:
Darragh Twomey; Moloy Das; Hariharan Subramanian; Joel Dunning
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2007-11-13
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  7     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-31     Completed Date:  2008-02-14     Revised Date:  2008-02-27    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  151-6     Citation Subset:  IM    
Affiliation:
Department of Cardiology, James Cook University Hospital, Middlesbrough, UK. darraghtwomey@doctors.org.uk
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MeSH Terms
Descriptor/Qualifier:
Decision Making
Heart Arrest / etiology,  therapy*
Heart Massage / methods*
Heart Valve Prosthesis Implantation / adverse effects*
Humans
Male
Middle Aged
Postoperative Complications
Comments/Corrections
Comment In:
Interact Cardiovasc Thorac Surg. 2008 Feb;7(1):156-7   [PMID:  18234781 ]
Interact Cardiovasc Thorac Surg. 2008 Feb;7(1):157   [PMID:  18234782 ]

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


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