Present Place of Open-Chest Cardiac Resuscitation

Abstract

The frontiers of resuscitation have expanded to the extent that resuscitative efforts are successfully employed daily in communities throughout the nation, both within and outside of the hospital environment, since a report by Kou-wenhoven et al in 1959 demonstrated the effectiveness of cardiopulmonary resuscitation through an unopened chest (1). The effectiveness of properly performed closed-chest resuscitation in establishing an effective tissue perfusion is clearly substantiated. It should be emphasized that there are, however, certain pathophysiologic considerations that contribute to ineffective closed-chest compression techniques and indicate more effective management by use of the direct or open-chest route. As a viable alternative procedure, the open-chest approach for direct cardiac compression should be a part of the physician’s armamentarium.