Open chest cardiac massage: A review

Emergency department thoracotomy in a patient with non-traumatic pulseless electrical activity: potential widening of the therapeutic horizon of a high-specialty intervention

“…As regards electrical therapy, studies on the care of cardiopulmonary arrest in critically injured patients, both in urban and military settings, including some resuscitations following EDT protocols, have failed to find statistical difference between core rhythms reversal rates obtained either with internal or external defibrillation [1][2][3][4][5][6][6][7][8]11,12 ; therefore, up to this moment, and with the available elements, it is not possible to determine if internal defibrillation is less beneficial than its external therapeutic counterpart.…”

“…In summary, EDT is a procedure that was born from the need to provide care for critically injured, agonizing patients. Within its institutional protocol, EDT includes essential aspects concerning cardiac massage, electric therapy and blood flow redistribution maneuvers (clamping of the descending thoracic aorta), which are fully applicable to the patient with non-traumatic PEA and that can significantly modify the natural course of the pathophysiology of cardiovascular collapse, thus promoting a benefit in the prognostic indexes related to survival and functionality [1][2][3][4][5][6][7][8][9][10][11][12] . However, global experience with this encouraging procedure is scarce and its true utility can only be proven with the passage of time and by acquiring experience with its use.…”

“…Unfortunately, since the popularization of closed chest compressions in the decade of 1960, direct cardiac massage with open chest fell into disuse, making for direct cardiac compressions to be rarely practiced outside surgical scenarios [4][5][6] . However, over the last 20 years, great experience has been gained with open cardiac massage resuscitation, mainly due to the analysis of the results obtained with the practice of EDT in trauma.…”

Report of the American Heart Association Task Force on the Future of Cardiopulmonary Resuscitation.

“…A number of clinical studies have reported initial resuscitation rates of 19-46%, and hospital discharge rates of 3-19% in selected groups of patients. [26][27][28][29][30] Open-chest cardiac massage was quickly displaced by the technique of closed-chest cardiac compression introduced in 1960. Combined with effective external defibrillation, closed-chest compression was appealing because it was easily taught, required no tools or advanced technical or surgical ability, and was bloodless.…”

Toracotomía en el departamento de urgencias en una paciente con actividad eléctrica sin pulso no traumática: potencial ampliación del horizonte terapéutico de una intervención de alta especialidad

“…Por mala fortuna, desde la popularización de las compresiones torácicas cerradas en la década de 1960, el masaje cardiaco directo con el tórax abierto cayó en desuso, haciendo que las compresiones cardiacas directas se practicaran rara vez fuera de los escenarios quirúrgicos [4][5][6] . Sin embargo, en los últimos 20 años se ha ganado gran experiencia con la reanimación con masaje cardiaco abierto, fundamentalmente debido al análisis de los resultados obtenidos con la práctica de la TDU en trauma.…”