Resuscitation Following Prolonged Cardiac Arrest

Abstract

If improved restoration of blood pressure and cardiac output could be provided by a method such as mechanical ventricular assistance (MVA), success in cardiac resuscitation might be more frequent. To investigate this possibility, cardiopulmonary resuscitation using MVA was compared to open-chest manual cardiac massage in two series of canine experiments. Of 16 dogs whose hearts were arrested for fifteen minutes, 7 of 8 given MVA were resuscitated and 4 survived more than 24 hours. Three regained reflexes, and I achieved pupillary miosis and spontaneous movement. Only 1 animal could be resuscitated by manual massage, and it died 2 hours later. Renal function was markedly better in animals given MVA during the first hour of resuscitation. In 12 other dogs whose hearts were arrested for twenty minutes, only 1 dog given MVA survived more than 24 hours. None given conventional resuscitation survived this long. In 7 human cadaver organ donors in whom conventional cardiopulmonary resuscitation had failed to restore any signs of organ function, renal output was reestablished in 4, cardiac action in 5, and cerebral function in 1 during MVA.