Six-year prospective audit of chest reopening after cardiac arrest

Abstract

This study strongly confirms the benefit of chest reopening after cardiac arrest in the cardiac surgical ICU. Patients who arrest within 24 h of surgery and in whom reopening is instituted within 10 min are particularly likely to benefit. The value of chest reopening in arrests outside the ICU remains unresolved. All patients reopened on the ward died, suggesting that this practice should be discontinued. Early 'scoop and run' resulted in one solitary survivor though it should probably be restricted to patients who arrest within 72 h of surgery as surgically remediable problems are unlikely after this time.

Part 8: Advanced Life Support

“…Eleven studies documented improvement in outcome in patients with cardiac arrest following cardiac surgery who were treated with resternotomy and internal cardiac compression compared with standard protocol, when administered by experienced personnel in ICUs (LOE 2 680,681 ; LOE 4 [682][683][684][685][686][687][688][689][690] 699,700 ). Three studies reported equivocal findings (LOE 5).…”

Kreislaufstillstand in besonderen Situationen

“…In der unmittelbar postoperativen Phase nach größeren herzchirurgischen Eingriffen ist ein Kreislaufstillstand recht üblich, die Inzidenz liegt bei 0,7-8,0 % [446][447][448][449][450][451][452][453][454][455]. Üblicherweise geht eine physiologische Verschlechterung voraus [456], er kann aber auch plötzlich bei stabilen Patienten auftreten [452] …”

Standards for Resuscitation After Cardiac Surgery

“…1,2 Improved survival is reported with prompt reoperation after cardiac surgical arrest: Mackay et al 18 reported a 48% survival rate when emergency resternotomy was performed within 10 minutes, as opposed to 12% when time to chest reopening was more prolonged.…”