The management of non-traumatic cardiac arrest in the operating room with cardiopulmonary bypass

We present a case of a 29-year-old woman whom, while undergoing an elective gynecological procedure, acutely arrested. Closed chest cardiopulmonary compressions were not effective. Fortuitously, the cardiac surgical team was in an adjacent operating room, about to start an elective bypass case. Afte...

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Bibliographic Details
Published in:Resuscitation 1999-03, Vol.40 (2), p.107-110
Main Authors: Karmy-Jones, Riyad, Hamilton, Andrew, Koshal, Arvind
Format: Article
Language:English
Subjects:
Adult
Anesthesia
Anesthesia depending on type of surgery
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Cardiopulmonary Bypass
Cardiopulmonary Resuscitation
Closed-chest CPR
Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care
Female
Heart Arrest - etiology
Heart Arrest - surgery
Humans
Hysterectomy
Intensive care medicine
Intraoperative Complications
Medical sciences
Open-chest CPR
Thoracic and cardiovascular surgery. Cardiopulmonary bypass
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Summary:We present a case of a 29-year-old woman whom, while undergoing an elective gynecological procedure, acutely arrested. Closed chest cardiopulmonary compressions were not effective. Fortuitously, the cardiac surgical team was in an adjacent operating room, about to start an elective bypass case. After sternotomy, the patient was placed on cardiopulmonary bypass within 20 min of the arrest. The patient achieved return of spontaneous circulation and was ultimately discharged with only mild extremity weakness. The etiology of the arrest was never fully explained. Open chest massage and cardiopulmonary bypass should be considered early in the management of unexpected cardiac arrest, especially in the operating room where surgical expertise should be immediately available. Surgeons and anesthesiologists need to be aware of, and consider, the possibility of employing these techniques.
ISSN:0300-9572
1873-1570
DOI:10.1016/S0300-9572(99)00009-X