Open-chest cardiac massage. The possible rebirth of an old procedure

Open-chest cardiac massage was widely and successfully used for many decades before its virtual abandonment 25 years ago. Both experimental evidence and basic physiologic evidence indicate that it has many advantages over closed-chest massage (especially increased cardiac output). Both resuscitation techniques have specific and unique advantages and disadvantages: They are not mutually exclusive. However, significant increases in rates of survival after cardiac arrest cannot be expected with variations of closed-chest cardiac massage and standard advanced life support services. Therefore, physicians must be willing to support controlled human studies that can definitively determine the proper role of each in resuscitation after cardiac arrest.