scholarly journals Head-down tilt position successfully prevent severe brain air embolism

2018 ◽  
Vol 6 ◽  
pp. 2050313X1880926 ◽  
Author(s):  
Gaku Yamaguchi ◽  
Hiroyuki Miura ◽  
Eiji Nakajima ◽  
Norihiko Ikeda
Keyword(s):  
Cardiac Arrest ◽  
Low Temperature ◽  
Brain Damage ◽  
Air Embolism ◽  
Cardiac Massage ◽  
Open Chest ◽  
Successful Recovery ◽  
Life Threatening ◽  
Margin Detection ◽  
Air Embolus

Air embolisms are rare life-threatening complications that develop under various conditions, including surgery. During segmentectomy for thoracic surgery, air is blown into the selected bronchus for segment margin detection. This may result in the formation of an air embolus. Herein, we report a case of successful recovery from sudden intraoperative cardiac arrest due to an air embolism in a patient undergoing left superior division segmentectomy via open thoracotomy. Intraoperatively, the patient was positioned head-down. Upon blowing air into the bronchus, the patient suddenly developed cardiac arrest. Open-chest cardiac massage and low-temperature therapy were commenced and the patient recovered. The head-down position prevents the air embolus from reaching the brain and thus prevents severe brain damage, whereas continuous open-chest massage and low temperature prevents severe body damage from anticipated cardiac air embolism. Thus, operation in the head-down position is useful in preventing severe brain damage from brain air embolisms.

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

1991 ◽  
Vol 20 (7) ◽  
pp. 761-767 ◽  
Author(s):  
Karl B Kern ◽  
Arthur B Sanders ◽  
Wolfgang Janas ◽  
James R Nelson ◽  
Stephen F Badylak ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiac Massage ◽  
Open Chest

Evaluating the effectiveness of resuscitation with extracorporeal membrane oxygenation in a model of acute hypoxic cardiac arrest in pigs (experimental study)

2014 ◽  
Vol 5 (4) ◽  
pp. 20-26
Author(s):  
Gennadiy Grigoryevich Khubulava ◽  
Aleksey Borisovich Naumov ◽  
Sergey Pavlovich Marchenko ◽  
Vitaliy Vladimirovich Suvorov ◽  
Igor Igorevich Averkin ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Extracorporeal Membrane Oxygenation ◽  
Circulatory Support ◽  
Cardiac Massage ◽  
Membrane Oxygenation ◽  
Neurologic Outcomes ◽  
Intergroup Comparison ◽  
Life Threatening ◽  
Switching Method

Cardiopulmonary resuscitation (CPR) with closed-chest cardiac massage was developed to maintain circulation and ventilation until life-threatening problems could be corrected or reversed. Studies on the effect of CPR have shown that about 80-95 % cases of resuscitation are fatal or severe neurological consequences and survival to discharge after CPR ranged from 6 to 22 % [2, 4, 8, 11]. Furthermore, the chances of survival decline rapidly if the resuscitation period more than 10 minute. At the same time, we know that successful neurologic outcomes are inversely associated with the time of brain hypoperfusion. Because of the low survival rate after prolonged CPR, more aggressive methods have been suggested to increase success. With the advancement of techniques, extracorporeal mechanical support has been applied in conjunction with CPR, with variable results [5, 12]. To assess the efficacy of resuscitation with extracorporeal membrane oxygenation was modeled the acute hypoxic cardiac arrest in pigs. Results of the study in the two groups demonstrate efficient switching method supporting circulatory support (ECMO) in the minutes of CPR. In the provision of an extended set of measures of cardiopulmonary resuscitation in the modeling of hypoxic cardiac arrest in animals in the group with ECMO received great survival to the end of the experiment, less expressed manifestations of acute heart failure. Intergroup comparison given the prerequisites for the development of protocols with the use of ECMO CPR, which would reduce the number of complications and death in patients undergoing cardiac surgery.

scholarly journals Considerations on Liver Injuries Caused by CPR Case Presentation

2015 ◽  
Vol 20 (2) ◽  
pp. 104-108
Author(s):  
Beatrice Ioan ◽  
Bianca Hanganu ◽  
Marius Neagu
Keyword(s):  
Cardiac Arrest ◽  
Cardiac Activity ◽  
Cardiac Massage ◽  
Injury Death ◽  
Emergency Team ◽  
Cardio Pulmonary Resuscitation ◽  
Life Saving ◽  
Threatening Condition ◽  
Life Threatening ◽  
Intraperitoneal Bleeding

Cardiac arrest is a life-threatening condition which requires fast maneuvers for saving the victim’s life. Cardio-pulmonary resuscitation (CPR) is one of the easiest and handiest maneuver which proved many times to be savior even though sometimes it could worsen the victim’s prognosis. In this paper the authors present the case of a 75-year old male, with a significant medical history and long term thrombolytic treatment who suffered a witnessed cardiac arrest. The emergency team who arrived at the victim’s home initiated the CPR and transported him to the hospital. The electrocardiogram showed inferior-lateral acute myocardial infarction and the cardiologist in the emergency room decided to transfer him to another hospital for specialized treatment. Despite the fact that the CPR was continued in the ambulance in order to maintain the cardiac activity, the blood pressure decreased gradually and he died couple of hours later. Internal examination at the autospy revealed multiple injuries caused by the cardiac massage: rib and sternum fractures, massive intraperitoneal bleeding, liver laceration and contusion. This paper brings to the attention of the physicians the issue of the iatrogenic injuries following the CPR and the possibility for these injuries to contribute to thanatogenesis. The authors also analyze the factors influencing the quality of the life-saving procedures and the role of the pathologist in establishing the correct cause of death taking into the gravity of the CPR related injuries.Keywords: CPR, liver injury, death

Rationale for Open-Chest Cardiopulmonary Resuscitation

1985 ◽  
Vol 1 (3) ◽  
pp. 242-244
Author(s):  
J.K. Alifimoff ◽  
K. Stajduhar ◽  
P. Safar ◽  
N. Bircher ◽  
R. Steinberg ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Life Support ◽  
Spontaneous Circulation ◽  
Laboratory Animals ◽  
Cardiac Massage ◽  
Extensive Experience ◽  
Open Chest ◽  
Penetrating Thoracic Trauma ◽  
Spine Deformities

Present national and international guidelines for resuscitation call for open-chest cardiopulmonary resuscitation (CPR) instead of standard external CPR under the following circumstances associated with pulselessness:1) chest already open;2) penetrating thoracic trauma;3) suspected intrathoracic hemorrhage;4) suspected pulmonary embolism (thoracotomy permits disruption or removal of emboli);5) deep hypothermia (open chest allows direct warming of the heart for defibrillation); and6) no palpable artificial pulse during standard external CPR basic life support, as is sometimes encountered in cases of barrel chest or spine deformities.We will present evidence in support of a 7th indication, that is when standard external CPR advanced life support efforts do not result in the prompt restoration of spontaneous circulation, as may be the case after prolonged unwitnessed cardiac arrest or in patients with severe myocardial disease.Historically, open-chest CPR has been used effectively to reverse cardiac arrest in laboratory animals since the 1980s and in patients since 1900. We conducted interviews with Drs. DelGuercio, Johnson, Stephenson and Leighninger (for Beck), who have had extensive experience with open-chest CPR. All confirmed personal experience of one of us (PS) with open-chest CPR in the 1950s, and anecdotal reports, that during direct cardiac massage, the heart usually regained color, spontaneous breathing returned, survivors had a very low incidence of neurologic deficit, and complications were almost non-existent. Stephenson's review of 1200 cases of open-chest CPR hospital-wide between 1900 and 1950 (1) report an overall recovery rate of 30%. However, after Kouwenhoven's report on closed-chest CPR in 1960 (2), open-chest CPR became a forgotten art.

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