Transthoracic pacing during CPR

摘要: Twenty-seven patients had transthoracic pacemakers inserted by the subxiphoid approach during advanced cardiopulmonary resuscitation (CPR) in emergency department of Detroit General Hospital between May 1977 and March 1979. Twenty-one charts were available for detailed review. Pacemaker indications these 21 cases included electromechanical dissociation four cases, asystole 10 pulseless idioventricular rhythm five 3 degree heart block two cases. All failed to respond conventional chronotropic inotropic agents prior pacemaker insertion. Good capture was obtained eight patients. Two with good pulses about 15 min after capture. One rearrested, signs pericardial tamponade which confirmed thoracotomy. Neither who insertion could be stabilized, both died within 30 post-insertion. Transthoracic CPR probably does not improve outcome bradyasystolic arrests if there has been poor response standard cardiac life support management.