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Related Experiment Videos

Transthoracic pacing during CPR

J E Tintinalli, B C White

    Annals of Emergency Medicine
    |February 1, 1981
    PubMed
    Summary
    This summary is machine-generated.

    Transthoracic pacemakers inserted during advanced cardiopulmonary resuscitation (CPR) showed limited benefit in bradyasystolic arrests. This emergency procedure likely does not improve outcomes when standard advanced cardiac life support management fails.

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    Area of Science:

    • Emergency Medicine
    • Cardiology
    • Critical Care Medicine

    Background:

    • Advanced cardiopulmonary resuscitation (CPR) is critical for patients with cardiac arrest.
    • Transthoracic pacing is a potential intervention during resuscitation efforts.
    • The efficacy of emergency transthoracic pacing in specific arrest rhythms remains under investigation.

    Purpose of the Study:

    • To evaluate the effectiveness of subxiphoid transthoracic pacemaker insertion during advanced CPR.
    • To assess outcomes in patients with bradyasystolic arrests refractory to conventional treatments.

    Main Methods:

    • Retrospective review of 21 patients undergoing subxiphoid transthoracic pacemaker insertion during advanced CPR.
    • Analysis of pacemaker indications including electromechanical dissociation, asystole, pulseless idioventricular rhythm, and heart block.

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  • Assessment of pacemaker capture and patient response post-insertion.

    • Main Results:

    • Good pacemaker capture was achieved in 8 of 21 patients.
    • Two patients with capture experienced transient pulses but could not be stabilized and died within 30 minutes.
    • One patient developed pericardial tamponade, confirmed during emergency thoracotomy.

    Conclusions:

    • Subxiphoid transthoracic pacemaker insertion during advanced CPR in the emergency department likely does not improve outcomes in bradyasystolic arrests.
    • The procedure showed minimal benefit, particularly when patients have a poor response to standard advanced cardiac life support management.