Prehospital Thoracotomy for Cardiac Arrest Due to Perforating Chest Wounds: Case Reports of Two Patients

T. Silfvast
1997 Prehospital and Disaster Medicine  
Objective: Different studies have demonstrated the respiratory effects associated with the use of the cardiopump during ACD-CPR in animal models. There is no study, however, demonstrating beneficial ventilatory effects of this tool in humans with cardiac arrest. The aim of this evaluation was to measure tidal volumes applied by the cardio-pump as used by medical personnel experienced in conventional cardiopulmonary resuscitation (CCPR). Materials and Methods: A 35 year-old normothermic male
more » ... a large posterior myocardial infarction underwent CCPR (38 minutes) followed by ACD-CPR (SO minutes) due to cardiac arrest. As resuscitative efforts remained unsuccessful, termination of the resuscitation was decided (total dose: 60 mg epinephrine). Minute volumes applied by the emergency physician and three EMTs during ACD-CPR were measured using a Draeger Oxylog 2000 in the CPAP mode (CPAP = 0), and the frequency of chest compressions was assessed using a Nellcor pulse oximeter. Shortly after the test, the patient showed return of spontaneous circulation (ROSC) and was transferred to the ICU. 50 minutes after ROSC, CCPR was continued for 30 minutes due to refractory pulseless electrical activity. Immediately after decision to stop CPR, two medical intensive care physicians and one ICU nurse continued with ACD-CPR. Minute volumes were measured with a Draeger Anemone volumeter. Additionally, arterial blood pressure during CCPR and ACD-CPR were recorded by a Siemens Sirecust 1281 Monitor via femoral artery catheter. All "rescuers" were blinded with respect to the measured parameters.
doi:10.1017/s1049023x00046574 fatcat:azdsg2in3be6zoj52irz7ggucq