Increased Survival from Cardiac Arrest Since the Introduction of External Massage

¹ Department of Surgery, Louisiana State University School of Medicine, and the Thoracic Surgery and Anesthesia Services of Charity Hospital

1. Hospital records of 73 patients treated for cardiac arrest at Charity Hospital from June, 1960 through March, 1962 are reviewed. Patients who developed cardiac arrest during or after cardiac or pulmonary operations are not included. There were 54 arrests in the operating room and 19 in other areas of the hospital.

2. Patients were classified according to type of resuscitative procedure employed. These included (1) closed chest massage, (2) open thoracotomy with massage, and (3) combined closed-open massage.

3. The survival rate in the operating room with closed massage as definitive therapy was 90 per cent and when instituted as a preliminary measure to open-chest massage was 35 per cent. There was a 63 per cent survival among all patients in whom closed massage was attempted in the operating room. When immediate thoracotomy was employed for cardiac arrest in the operating room, the survival rate was 21 per cent.

The overall survival from cardiac arrests in the operating room was 52 per cent.

4. The number of patients resuscitated outside of the operating room is too small to allow any general conclusion. The three survivors reported demonstrate the value of closed chest massage as definitive therapy in cardiac arrest and as a preliminary measure to allow proper preparation for open cardiac resuscitation. There was no patient with cardiac arrest outside the operating room successfully resuscitated with primary open massage.

5. This study demonstrates that as the resident staff of the hospital became more familiar with the technique of external cardiac message, the incidence of open thoracotomy decreased and the survival rate from cardiac arrest increased.

6 External or closed cardiac massage has significantly improved survival from cardiac arrest in the operating room and has resulted in successful resuscitation in other areas of the hospital where cardiac arrest is almost always irreversible.