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At least 307 records · Page 17Linked to original sources
PubMed1994

Resuscitation after modified Fontan procedure.

As the survival rate after modified Fontan procedure is increasing, cardiopulmonary resuscitation may be needed in such patients for other causes not related to their cardiac status. The state-of-the-art cardiopulmonary resuscitation with external chest compression may not be sufficient to revive such patients, and the addition of external abdominal compressions may help in the final outcome, as is reported here.

Abnormalities, Multiple↗
PubMed1996

Surviving resuscitation: successful repair of cardiac rupture.

An 83-year-old man was found unconscious and was successfully resuscitated. Progressive cardiac failure developed. After 42 hours of observation echocardiography revealed cardiac tamponade and a discontinuity in the left atrial wall. Exploration showed a laceration of the left atrium at the junction of the left pulmonary veins, which was closed with a direct suture on cardiopulmonary bypass. The postoperative course was uneventful.

Aged↗
PubMed1991

Evidence for the 'cardiac pump theory' in cardiopulmonary resuscitation in man by transesophageal echocardiography.

There are two theories to explain the mechanism of blood flow during cardiopulmonary resuscitation: The 'Cardiac Pump Theory' and the 'Thoracic Pump Theory'. We have performed transesophageal echocardiography during the resuscitation of a patient with cardiopulmonary arrest. By this method we could study the motion of the aortic, mitral and tricuspid valves and the changes in ventricular size during cardiopulmonary resuscitation in man. We demonstrated an opening of the aortic valve during thoracic compression with simultaneous closure of the mitral and tricuspid valves. During relaxation of the chest, a rapid opening of the atrioventricular valves and closure of the aortic valve was noted. Short interruption of cardiopulmonary resuscitation to test for spontaneous heart action lead to echocontrast in all four heart chambers through stasis of blood, which resolved on continuation of cardiopulmonary resuscitation. This 'washing out' phenomenon enables visualization of blood flow through the aortic valve during compression, and through the mitral valve during relaxation. These observations favour the Cardiac Pump Theory as the predominant hemodynamic principle of blood flow during cardiopulmonary resuscitation in man.

Aged↗
PubMed1993

Potential risks of high-dose epinephrine for resuscitation from ventricular fibrillation in a porcine model.

The arterial plasma concentrations and hemodynamic effects of epinephrine, 10 micrograms/kg, IV (group A, N = 8) and 50 micrograms/kg, IV (group B, N = 8) were compared in a porcine resuscitation model after 3 minutes of circulatory arrest induced by ventricular fibrillation. All animals in group A were successfully resuscitated after 4.9 +/- 2.8 minutes and 2.8 +/- 1.6 defibrillations. In group B, only 6 of 8 animals were successfully resuscitated after 6.3 +/- 1.1 minutes and 4.0 +/- 2.7 defibrillations (mean +/- SD). During CPR, cardiac output (CO), left ventricular systolic pressure (LVSP), and mean arterial pressure (MAP) were nearly identical in the groups. The hemodynamic situation during the first hour after restitution of spontaneous circulation in group B was characterized by a significantly higher heart rate, combined with significantly lower values for cardiac inotropy, CO, LVSP, and MAP compared to group A. Mean arterial peak epinephrine concentrations (group A 197 +/- 133 ng/mL, group B 1173 +/- 298 ng/mL) were approximately fivefold higher in group B. After resuscitation, plasma concentrations returned to baseline levels within 7 minutes in group A and 15 minutes in group B. Later hemodynamic differences between the groups are thereby attributed to a detrimental impact of high-dose epinephrine on the heart during resuscitation.

Animals↗
PubMed1975

Mechanisms of reflex cardiac arrest in tetraplegic patients.

Four patients with physiologically complete high cervical spinal-cord lesions, sustained within the previous 6 weeks, were observed. All needed intermittent positive-pressure ventilation. In the stage of spinal shock, stimuli to the trachea induced bradycardia, and in two patients cardiac arrest resulted. The bradycardia occurred when the patients were hypoxic, and seemed to be due to a vaso-vagal reflex. Normally this reflex is opposed by sympathetic activity, and during hypoxia by increased pulmonary (inflation) vagal reflex activity due to increased breathing. In these patients, however, compensatory sympathetic activity was prevented by the cervical cord lesion, and increased pulmonary vagal reflex activity by the fact that the breathing was artificial and therefore did not increase with hypoxia. Treatment in emergency includes the administration of atropine. Adequate oxygenation and, if this cannot be achieved, maintenance atropin should prevent the bradycardia and cardiac arrest associated with stimulation of the trachea in artificially ventilated tetraplegic patients.

Adolescent↗
PubMed2001

Successful resuscitation after catastrophic carbon dioxide embolism during laparoscopic cholecystectomy.

A 92-year-old female was scheduled for laparoscopic cholecystectomy. Following intraperitoneal carbon dioxide insufflation and removal of her gallbladder, the patient developed serious haemodynamic deterioration associated with a decrease of both end-tidal carbon dioxide concentration (ETCO2) and chest compliance. Carbon dioxide embolism was suspected and the diagnosis was confirmed by aspiration of 20 mL of foamy blood from the central venous line. The patient was successfully resuscitated after discontinuation of carbon dioxide insufflation and ventilation of the lungs with 100% oxygen. Carbon dioxide embolization must always be suspected during laparoscopic surgery whenever sudden haemodynamic deterioration associated with a decrease in ETCO2 and chest compliance occur.

Aged↗