PREVENTION OF CARDIAC ARREST DURING SURGERY

Abstract

SUMMARY Cardiac arrest during surgery is increasing in the United States and, therefore, all possible measures to avoid this catastrophe must be provided. Cardiac arrest is not a completely unheralded event, but is preceded by definite prodromal signs. Conventional methods of monitoring are often inadequate in detecting these prodromal changes. The plan adopted in our institution of oscilloscopic monitoring of the electrocardiogram with auditory monitoring of the cardiac rate and rhythm allows for immediate detection of prodromata, and treatment can be instituted at the very onset. For patients with known cardiac pathology and patients considered to be poor surgical risks, both electrocardiographic and electroencephalographic monitoring are done; thus, the incidence of cardiac arrest in the operating room may be markedly reduced. In a two-year period, there were 12 patients in whom the prodromata of cardiac arrest were manifest. Appropriate treatment corrected the prodromal signs in 11 patients, but was unsuccessful in one. It is our feeling that myocardial hypoxia, for one reason or another, is the most common factor in precipitating the prodromata of cardiac arrest.