Document Detail

A study of the techniques of cardiac massage with the abdomen open.
MedLine Citation:
PMID:  4049254     Owner:  NLM     Status:  MEDLINE    
The present study compares the hemodynamic effectiveness of closed-chest cardiac massage (CCCM) with closed subdiaphragmatic massage (CSDM) and four open transdiaphragmatic cardiac massage techniques during cardiac arrest with an open abdomen. In 10 dogs CCCM resulted in the lowest cardiac index (CI), mean arterial pressure (MBP), and carotid blood flow (CBF) of all cardiac massage techniques tested. CSDM was not statistically superior to CCCM in the dog (p greater than 0.05) but did result in a 23% increase in CI and a 54% increase in CBF. Transdiaphragmatic retrocardiac massage through an incision in the diaphragm resulted in the highest CI, MBP, and CBF of all the four open transdiaphragmatic techniques and had significantly higher values than those for CCCM in the dog (p less than 0.05). In three cadaveric renal donors, all four open transdiaphragmatic techniques and CSDM were noted to be equal to or superior to CCCM. Three patients have been successfully resuscitated with diaphragmatic cardiac massage techniques for cardiac arrest while undergoing abdominal operations. These studies reveal that all subdiaphragmatic or transdiaphragmatic techniques for cardiac massage are hemodynamically equivalent to or superior to the standard CCCM without such complications as fractured ribs and should be considered the treatment of choice for cardiac arrest in the patient with an open abdomen.
C F Rieder; B G Crawford; J I Iliopoulos; J H Thomas; G E Pierce; A S Hermreck
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Surgery     Volume:  98     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1985 Oct 
Date Detail:
Created Date:  1985-11-01     Completed Date:  1985-11-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  824-30     Citation Subset:  AIM; IM    
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MeSH Terms
Abdomen / surgery*
Adenocarcinoma / physiopathology,  surgery
Blood Pressure
Carotid Arteries / physiology
Heart Arrest, Induced*
Heart Massage / methods*
Muscle Relaxation
Rectal Neoplasms / physiopathology,  surgery
Regional Blood Flow

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

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