Resuscitative thoracotomies and open chest cardiac compressions in non-traumatic cardiac arrest

Kornhall, Daniel; Dolven, Thomas

doi:10.1186/1749-7922-9-54

Cited by 15 publications

(19 citation statements)

References 36 publications

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“…Open-chest CPR produces better coronary perfusion coronary pressure than standard CPR and may be indicated for patients with cardiac arrest caused by trauma, 781 in the early postoperative phase after cardiothoracic surgery 782,783 (see Section 4special circumstances 224 ) or when the chest or abdomen is already open (transdiaphragmatic approach), for example, in trauma surgery. 784…”

Section: Open-chest Cprmentioning

confidence: 99%

European Resuscitation Council Guidelines for Resuscitation 2015

et al. 2015

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These Guidelines are based on the International Liaison Committee on Resuscitation (ILCOR) 2015 Consensus on Science and Treatment Recommendations (CoSTR) for ALS. 4 The 2015 ILCOR review focused on 42 topics organised in the approximate sequence of ALS interventions: defibrillation, airway, oxygenation and ventilation, circulatory support, monitoring during CPR, and drugs during CPR. For these Guidelines the ILCOR recommendations were supplemented by focused literature reviews undertaken by the ERC ALS Writing Group for those topics not reviewed in the 2015 ILCOR CoSTR. Guidelines were drafted and agreed by the ALS Writing Group members before final approval by the ERC General Assembly and ERC Board. Summary of changes since 2010 GuidelinesThe 2015 ERC ALS Guidelines have a change in emphasis aimed at improved care and implementation of these guidelines in order to improve patient focused outcomes. 5 The 2015 ERC ALS Guidelines do not include any major changes in core ALS interventions since the previous ERC guidelines published in 2010. 1,2 The key changes since 2010 are:• Continuing emphasis on the use of rapid response systems for care of the deteriorating patient and prevention of in-hospital cardiac arrest. • Continued emphasis on minimally interrupted high-quality chest compressions throughout any ALS intervention: chest

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Section: Open-chest Cprmentioning

confidence: 99%

European Resuscitation Council Guidelines for Resuscitation 2015

et al. 2015

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“…Als letzte Therapieoption ist die chirurgische Revision in etwa 3 % der Fälle unvermeidbar und sollte unverzüglich erfolgen [108]. Im Rahmen einer foudroyanten Blutung und fulminanten Kreislaufdepression des Patienten kann die chirurgische Exploration im Einzelfall bettseitig notwendig werden [109].…”

Section: Revisionseingriffunclassified

Behandlungsprinzipien in der herzchirurgischen Intensivmedizin

Breuer¹,

Marx²

2020

Intensivmedizin up2date

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“…Although multiple peer review articles document the outcome of CPR in a veterinary clinical setting, none of these primarily address OCCPR. In the human literature, OCCPR has been recommended in patients with penetrating thoracic wounds (especially stab wounds with cardiac tamponade) after pneumonectomy, for women in late pregnancy, or for patients with flail chest . The use of OCCPR in other cases of cardiac arrest remains controversial.…”

Section: Introductionmentioning

confidence: 99%

“…The use of OCCPR in other cases of cardiac arrest remains controversial. The recent interest in OCCPR techniques, including a transdiaphragmatic (TD) approach, has surged from the relatively static outcomes of human CPR …”

Section: Introductionmentioning

confidence: 99%

Feasibility of open‐chest cardiopulmonary resuscitation through a transdiaphragmatic approach in dogs

et al. 2019

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Objective: To describe and evaluate the feasibility of a transdiaphragmatic (TD) approach for open-chest cardiopulmonary resuscitation (OCCPR) as an alternative to a traditional lateral thoracotomy (LT) in a canine cadaver model. Study design: Randomized noninferiority ex vivo study.Animals: Fourteen canine cadavers weighing 17.4-30.2 kg. Methods: An LT and a TD approach to the heart were performed in each cadaver.The order of procedures as well as an assignment to specific operators were randomized before starting the study. Data recorded included the time between incision and initiation of cardiac compressions; time between initiation of the first suture placement and closure of the intrapleural space; time between initiation of the first suture placement and final skin suture; trauma to pulmonary, cardiac, hepatic and neurovascular structures; distance between the caval foramen and diaphragmatic incision; the intercostal space entered during LT; and appropriate closure. Results: The mean time between incision and initiation of cardiac compressions for the TD approach (85 ± 35 seconds) was noninferior to the LT (84 ± 28 seconds).The pleural space was closed faster after the TD approach (531 ± 276 seconds) than after the lateral approach (817 ± 294 seconds, P = .03). Total duration of closure did not differ between techniques (P = .11). There was no difference between the complication rates of each approach. Conclusion: The TD approach did not prolong the procedure or increase the complication rate compared with an LT. Clinical significance: This study provides evidence to support additional investigation of the TD approach for OCCPR to determine its efficacy and safety in live animals.

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Resuscitative thoracotomies and open chest cardiac compressions in non-traumatic cardiac arrest

Cited by 15 publications

References 36 publications

European Resuscitation Council Guidelines for Resuscitation 2015

European Resuscitation Council Guidelines for Resuscitation 2015

Behandlungsprinzipien in der herzchirurgischen Intensivmedizin

Feasibility of open‐chest cardiopulmonary resuscitation through a transdiaphragmatic approach in dogs

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