Article

Cardiac Arrest

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Abstract

UNEXPECTED cessation of the heart beat is the most serious of all operating room complications. If the patient does not have underlying cardiac disease this complication must be attributed directly to the anesthesia or to the surgical procedure. Popular acceptance of an entity is always followed by apparent increase in incidence; nevertheless we believe that cardiac arrest is occurring with greater frequency. We attribute this to more complicated anesthetic technic coupled with the surgeon’s demand for longer and deeper level anesthesia. As more cases of cardiac arrest are reported, the emphasis appears to be on recognition and immediate therapy by surgical intervention. Equally important, in our opinion, is the greater need for emphasizing the cause of this unfortunate complication and its prevention.

Experience

During the last 4 years there have been 19 cases of proved cardiac arrest in the Cleveland Clinic. Prior to this time there were operating room deaths attributed to various causes such as apoplexy, coronary occlusion, embolus, drug reaction, status thymicolymphaticus, and shock; cardiac arrest, as a clinical entity, was not known. Regardless of the true cause of death in the early series, the present group of 19 proved cases represents a distinct increase in incidence. By “proved cases” we mean visual evidence of cardiac arrest during thoracotomy for resuscitation. Severe cyanosis, accompanied by imperceptible pulse, heart beat and blood pressure, is not conclusive evidence of arrest; as mentioned by Lahey and Ruzicka, spontaneous recovery may occur in this formidable state.1 Spontaneous recovery does not occur in. . .


 

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