[Significance of cardiopulmonary resuscitation in thoracic surgery]

45 patients admitted in the thoracic non-cardiac surgery service of the U.L.B. between 1966 and 1983 (17 yrs) were short- or longterm survivors of cardiopulmonary resuscitation. In november 1979 the traditional system was supplanted by a mobile unit with reduction of the interval between cardiopulmonary arrest and resuscitation to 1 minute. The obtained results are as follows: A mobile thoracic wall or intra-thoracic visceral lesions or displacement of thoracic content secondary to a recent thoracic intervention or serious injury do not constitute a contra-indication. Closed chest massage was mainly applied. Displacement of the heart secondary to chronic tuberculosis or pneumonectomy or serious thoracic injury are not formal contra-indications. Open cardiac massage was applied during surgical interventions or with hypovolemic shock secondary to massive intra-thoracic hemorrhage or cardiac tamponade. Pulmonary resuscitation with extra-corporeal circulation was only applied when mechanical ventilation did not suffice. All patients succumbed due to an associated lung involvement with destruction of the pulmonary parenchyma. The use of a mobile unit increased the number of successful resuscitations but did not change at all the duration of survival of the patients nor the number of neurological deficits. The survival time was only affected by 2 factors; the primary disease for which the patient was hospitalized and the presumed cause of arrest. All the other factors had no influence on the duration of survival; a. type of intervention; b. place of C.P. arrest and c. method of resuscitation.