Limitations of open-chest cardiac massage after prolonged, untreated cardiac arrest in dogs

Karl B Kern, Arthur B Sanders, Wolfgang Janas, James R. Nelson, Stephen F. Badylak, Charles F. Babbs, Willis A. Tacker, Gordon A. Ewy

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Study objectives: Open-chest cardiac massage is an effective method of resuscitation if instituted within 15 minutes of normothermic cardiac arrest that has failed to respond to ongoing closed-chest CPR efforts. The usefulness of invasive forms of CPR after various periods of untreated cardiac arrest is less certain. This study was performed to determine the effectiveness of open-chest resuscitation after prolonged periods of untreated cardiac arrest. Setting and design: Prospective, controlled laboratory investigation using an animal model of cardiac arrest. Open-chest cardiac massage initially was compared to standard closed-chest compression CPR. The efficacy of open-chest CPR then was evaluated after ten and 40 minutes of untreated ventricular fibrillation. Type of participants: Twenty mongrel dogs (24 ± 1 kg). Measurements and main results: After 20 minutes of untreated ventricular fibrillation, open-chest resuscitation was significantly better than closed-chest efforts for the production of coronary perfusion pressure (58 ± 14 vs 2 ± 1 mm Hg; P < .05) and initial resuscitation success (five of five vs one of five; P < .03). Open-chest cardiac massage was equally effective for initial resuscitation if begun after ten or 20 minutes of untreated ventricular fibrillation (five of five vs five of five), but if untreated ventricular fibrillation continued for 40 minutes prior to instituting open-chest massage, no resuscitation benefit was found (none of five; P < .005). There were marked differences in 24-hour survival depending on the length of time untreated cardiac arrest continued prior to instituting open-chest resuscitation efforts. After 20 minutes of ventricular fibrillation, initial resuscitation was successful with open-chest massage, but long-term survival was poor. Conclusion: Open-chest cardiac massage did not produce long-term survival if untreated cardiac arrest persisted for 20 or more minutes prior to invasive resuscitation efforts.

Original languageEnglish (US)
Pages (from-to)761-767
Number of pages7
JournalAnnals of Emergency Medicine
Volume20
Issue number7
DOIs
StatePublished - 1991

Fingerprint

Heart Massage
Heart Arrest
Thorax
Dogs
Resuscitation
Ventricular Fibrillation
Cardiopulmonary Resuscitation
Massage

Keywords

  • open-chest cardiac massage

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Limitations of open-chest cardiac massage after prolonged, untreated cardiac arrest in dogs. / Kern, Karl B; Sanders, Arthur B; Janas, Wolfgang; Nelson, James R.; Badylak, Stephen F.; Babbs, Charles F.; Tacker, Willis A.; Ewy, Gordon A.

In: Annals of Emergency Medicine, Vol. 20, No. 7, 1991, p. 761-767.

Research output: Contribution to journalArticle

Kern, Karl B ; Sanders, Arthur B ; Janas, Wolfgang ; Nelson, James R. ; Badylak, Stephen F. ; Babbs, Charles F. ; Tacker, Willis A. ; Ewy, Gordon A. / Limitations of open-chest cardiac massage after prolonged, untreated cardiac arrest in dogs. In: Annals of Emergency Medicine. 1991 ; Vol. 20, No. 7. pp. 761-767.
@article{f037978fcd594bd7b2f2ae28ca64d7be,
title = "Limitations of open-chest cardiac massage after prolonged, untreated cardiac arrest in dogs",
abstract = "Study objectives: Open-chest cardiac massage is an effective method of resuscitation if instituted within 15 minutes of normothermic cardiac arrest that has failed to respond to ongoing closed-chest CPR efforts. The usefulness of invasive forms of CPR after various periods of untreated cardiac arrest is less certain. This study was performed to determine the effectiveness of open-chest resuscitation after prolonged periods of untreated cardiac arrest. Setting and design: Prospective, controlled laboratory investigation using an animal model of cardiac arrest. Open-chest cardiac massage initially was compared to standard closed-chest compression CPR. The efficacy of open-chest CPR then was evaluated after ten and 40 minutes of untreated ventricular fibrillation. Type of participants: Twenty mongrel dogs (24 ± 1 kg). Measurements and main results: After 20 minutes of untreated ventricular fibrillation, open-chest resuscitation was significantly better than closed-chest efforts for the production of coronary perfusion pressure (58 ± 14 vs 2 ± 1 mm Hg; P < .05) and initial resuscitation success (five of five vs one of five; P < .03). Open-chest cardiac massage was equally effective for initial resuscitation if begun after ten or 20 minutes of untreated ventricular fibrillation (five of five vs five of five), but if untreated ventricular fibrillation continued for 40 minutes prior to instituting open-chest massage, no resuscitation benefit was found (none of five; P < .005). There were marked differences in 24-hour survival depending on the length of time untreated cardiac arrest continued prior to instituting open-chest resuscitation efforts. After 20 minutes of ventricular fibrillation, initial resuscitation was successful with open-chest massage, but long-term survival was poor. Conclusion: Open-chest cardiac massage did not produce long-term survival if untreated cardiac arrest persisted for 20 or more minutes prior to invasive resuscitation efforts.",
keywords = "open-chest cardiac massage",
author = "Kern, {Karl B} and Sanders, {Arthur B} and Wolfgang Janas and Nelson, {James R.} and Badylak, {Stephen F.} and Babbs, {Charles F.} and Tacker, {Willis A.} and Ewy, {Gordon A.}",
year = "1991",
doi = "10.1016/S0196-0644(05)80838-8",
language = "English (US)",
volume = "20",
pages = "761--767",
journal = "Annals of Emergency Medicine",
issn = "0196-0644",
publisher = "Mosby Inc.",
number = "7",

}

TY - JOUR

T1 - Limitations of open-chest cardiac massage after prolonged, untreated cardiac arrest in dogs

AU - Kern, Karl B

AU - Sanders, Arthur B

AU - Janas, Wolfgang

AU - Nelson, James R.

AU - Badylak, Stephen F.

AU - Babbs, Charles F.

AU - Tacker, Willis A.

AU - Ewy, Gordon A.

PY - 1991

Y1 - 1991

N2 - Study objectives: Open-chest cardiac massage is an effective method of resuscitation if instituted within 15 minutes of normothermic cardiac arrest that has failed to respond to ongoing closed-chest CPR efforts. The usefulness of invasive forms of CPR after various periods of untreated cardiac arrest is less certain. This study was performed to determine the effectiveness of open-chest resuscitation after prolonged periods of untreated cardiac arrest. Setting and design: Prospective, controlled laboratory investigation using an animal model of cardiac arrest. Open-chest cardiac massage initially was compared to standard closed-chest compression CPR. The efficacy of open-chest CPR then was evaluated after ten and 40 minutes of untreated ventricular fibrillation. Type of participants: Twenty mongrel dogs (24 ± 1 kg). Measurements and main results: After 20 minutes of untreated ventricular fibrillation, open-chest resuscitation was significantly better than closed-chest efforts for the production of coronary perfusion pressure (58 ± 14 vs 2 ± 1 mm Hg; P < .05) and initial resuscitation success (five of five vs one of five; P < .03). Open-chest cardiac massage was equally effective for initial resuscitation if begun after ten or 20 minutes of untreated ventricular fibrillation (five of five vs five of five), but if untreated ventricular fibrillation continued for 40 minutes prior to instituting open-chest massage, no resuscitation benefit was found (none of five; P < .005). There were marked differences in 24-hour survival depending on the length of time untreated cardiac arrest continued prior to instituting open-chest resuscitation efforts. After 20 minutes of ventricular fibrillation, initial resuscitation was successful with open-chest massage, but long-term survival was poor. Conclusion: Open-chest cardiac massage did not produce long-term survival if untreated cardiac arrest persisted for 20 or more minutes prior to invasive resuscitation efforts.

AB - Study objectives: Open-chest cardiac massage is an effective method of resuscitation if instituted within 15 minutes of normothermic cardiac arrest that has failed to respond to ongoing closed-chest CPR efforts. The usefulness of invasive forms of CPR after various periods of untreated cardiac arrest is less certain. This study was performed to determine the effectiveness of open-chest resuscitation after prolonged periods of untreated cardiac arrest. Setting and design: Prospective, controlled laboratory investigation using an animal model of cardiac arrest. Open-chest cardiac massage initially was compared to standard closed-chest compression CPR. The efficacy of open-chest CPR then was evaluated after ten and 40 minutes of untreated ventricular fibrillation. Type of participants: Twenty mongrel dogs (24 ± 1 kg). Measurements and main results: After 20 minutes of untreated ventricular fibrillation, open-chest resuscitation was significantly better than closed-chest efforts for the production of coronary perfusion pressure (58 ± 14 vs 2 ± 1 mm Hg; P < .05) and initial resuscitation success (five of five vs one of five; P < .03). Open-chest cardiac massage was equally effective for initial resuscitation if begun after ten or 20 minutes of untreated ventricular fibrillation (five of five vs five of five), but if untreated ventricular fibrillation continued for 40 minutes prior to instituting open-chest massage, no resuscitation benefit was found (none of five; P < .005). There were marked differences in 24-hour survival depending on the length of time untreated cardiac arrest continued prior to instituting open-chest resuscitation efforts. After 20 minutes of ventricular fibrillation, initial resuscitation was successful with open-chest massage, but long-term survival was poor. Conclusion: Open-chest cardiac massage did not produce long-term survival if untreated cardiac arrest persisted for 20 or more minutes prior to invasive resuscitation efforts.

KW - open-chest cardiac massage

UR - http://www.scopus.com/inward/record.url?scp=0025892798&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025892798&partnerID=8YFLogxK

U2 - 10.1016/S0196-0644(05)80838-8

DO - 10.1016/S0196-0644(05)80838-8

M3 - Article

C2 - 2064097

AN - SCOPUS:0025892798

VL - 20

SP - 761

EP - 767

JO - Annals of Emergency Medicine

JF - Annals of Emergency Medicine

SN - 0196-0644

IS - 7

ER -