Experiences with Cardiopulmonary Resuscitation

Abstract

During the course of our practice of thoracic surgery, including over 1,000 thoracotomies, measures for cardiopulmonary resuscitation have been employed in 35 instances. The aim of such procedures has been to provide artificial support of ventilation and circulation. In maintaining such support strenuous attempts were made both to reverse the effects of the temporary cessation of circulation and to correct the predisposing or precipitating factors. In each instance ventilatory assistance was accomplished by positive pressure breathing carried out by an anesthetist either through an endotracheal tube or a cuffed tracheostomy tube. Prior to 1960, circulatory assistance was provided by manual cardiac massage carried out through the opened chest. Since then, cardiac massage has been performed utilizing closed-chest methods of sternal compression. A review of the salient aspects of this experience pertains to the relative effectiveness of the open and closed methods of cardiac massage and to the present and future