Hemodynamic effects of closed and open chest cardiac resuscitation in normal dogs and those with acute myocardial infarction

Experiments under controlled conditions were conducted to compare the hemodynamic effects of open and closed chest cardiac compression in normal dogs and in those with acute myocardial infarction. Cardiac outputs (dye-dilution method), central aortic systolic, diastolic and mean pressures were recor...

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Veröffentlicht in:The American journal of cardiology 1962-10, Vol.10 (4), p.555-561
Hauptverfasser: Weiser, Frank M., Adler, Lawrence N., Kuhn, Leslie A.
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Sprache:eng
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Zusammenfassung:Experiments under controlled conditions were conducted to compare the hemodynamic effects of open and closed chest cardiac compression in normal dogs and in those with acute myocardial infarction. Cardiac outputs (dye-dilution method), central aortic systolic, diastolic and mean pressures were recorded prior to electrically induced ventricular fibrillation and during fibrillation while closed and then open-chest cardiac compression was in progress in the same animal. Twelve normal dogs and 10 with acute myocardial infarction induced by plastic sphere coronary artery embolization were studied in this manner. The results indicate that the open chest method generally provides greater cardiac output (average 61 per cent of control values), and greater aortic systolic, diastolic and mean pressures (48 per cent of control mean aortic pressure) than the closed chest technic (20 per cent and 21 per cent respectively), in both groups of animals. However, higher cardiac outputs were obtained with closed chest massage in smaller dogs than in larger ones (39 per cent vs. 13 per cent of control values), but even with small dogs the cardiac outputs with closed chest compression were less than with open chest cardiac compression. Systolic ejection period and stroke volume were considerably diminished with the closed technic and, therefore, a rapid rate of compression (120/min.) was more effective than slower rates. With direct heart compression, rates of 30 to 60 per minute were most efficacious. With either technic the administration of epinephrine during massage resulted in increased values of the systolic, diastolic and mean aortic pressures. It is concluded that under ideal conditions permitting a choice of cardiac resuscitation technic, the direct open chest method of cardiac compression produces, in the dog, hemodynamic responses more nearly approaching the normal state than the closed chest technic.
ISSN:0002-9149
1879-1913
DOI:10.1016/0002-9149(62)90382-X