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Open indirect cardiac massage in neonate
Neeraj Saxena1, Sujata Chaudhary
1Department of Anaesthesiology and Critical Care, University College of Medical Sciences Warrington, United Kingdom. drneesax@yahoo.co.uk
Indian Journal of Pediatrics
|April 7, 2005
Summary
This study presents a novel resuscitation technique for neonates experiencing cardiac arrest during surgery. An innovative infra-diaphragmatic approach to open cardiac massage successfully restored circulation, leading to recovery.
Area of Science:
- Neonatal Resuscitation
- Cardiac Surgery
- Pediatric Cardiology
Background:
- Open, direct cardiac massage (OCM) has limitations in neonatal resuscitation.
- Neonatal cardiac arrest during surgery requires immediate and effective intervention.
Observation:
- A 24-hour-old neonate with gastrointestinal anomalies underwent emergency laparotomy and experienced intraoperative cardiac arrest.
- External chest compressions (ECC) were ineffective in restoring circulation.
Findings:
- Surgeons successfully employed an 'open indirect' cardiac massage technique via an infra-diaphragmatic approach.
- This method allowed direct cardiac compression without diaphragm splitting, achieving adequate circulation.
Implications:
- This infra-diaphragmatic approach offers a viable alternative for neonatal resuscitation during cardiac arrest.
- Successful application suggests potential for improved outcomes in complex neonatal surgical cases.
- Further research into this technique could refine neonatal cardiac arrest management protocols.