Long-term survival with open-chest cardiac massage after ineffective closed-chest compression in a canine preparation

Karl B Kern, Arthur B Sanders, S. F. Badylak, W. Janas, A. B. Carter, W. A. Tacker, G. A. Ewy

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

The ultimate goal of cardiopulmonary resuscitation (CPR) is long-term, neurologically intact survival. This study examined whether open-chest cardiac massage could improve 7 day survival and neurologic function when instituted after the failure of standard closed-chest compression CPR. Twenty-nine mongrel dogs were anesthetized and then instrumented with catheters to monitor right atrial and ascending aortic pressures. Ventricular fibrillation was induced and after 3 min standard CPR was begun. Standard CPR was performed with a Thumper programmed for 2 inch chest compressions at 60/min with a 50% duty cycle. External defibrillation was attempted twice after 15 min of ventricular fibrillation. Unsuccessfully defibrillated animals were randomly assigned to either an additional 2 min of continued closed-chest compressions, or 2 min of open-chest cardiac massage. All animals underwent a period of advanced cardiac life support and were followed until they were resuscitated or died. Follow-up care, including scoring of neurologic deficit, was performed for 7 days. In dogs receiving open-chest cardiac massage there was significantly more immediate resuscitation success (14/14 vs 5/14; p < .005), 24 hr survival (12/14 vs 4/14; p < .005), and 7 day survival (11/14 vs 4/14; p < .02) than in those receiving continued closed-chest compression. Open-chest cardiac massage significantly improved long-term outcome when instituted after 15 min of ineffective closed-chest compression.

Original languageEnglish (US)
Pages (from-to)498-503
Number of pages6
JournalCirculation
Volume75
Issue number2
StatePublished - 1987
Externally publishedYes

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Heart Massage
Canidae
Thorax
Cardiopulmonary Resuscitation
Ventricular Fibrillation
Advanced Cardiac Life Support
Dogs
Aftercare
Neurologic Manifestations
Resuscitation
Nervous System
Arterial Pressure
Catheters

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Long-term survival with open-chest cardiac massage after ineffective closed-chest compression in a canine preparation. / Kern, Karl B; Sanders, Arthur B; Badylak, S. F.; Janas, W.; Carter, A. B.; Tacker, W. A.; Ewy, G. A.

In: Circulation, Vol. 75, No. 2, 1987, p. 498-503.

Research output: Contribution to journalArticle

Kern, Karl B ; Sanders, Arthur B ; Badylak, S. F. ; Janas, W. ; Carter, A. B. ; Tacker, W. A. ; Ewy, G. A. / Long-term survival with open-chest cardiac massage after ineffective closed-chest compression in a canine preparation. In: Circulation. 1987 ; Vol. 75, No. 2. pp. 498-503.
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