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Efficacy and safety of a device for minimally invasive direct cardiac masage

Evidence exists in the literature, mainly in experimental studies, that internal cardiac massage is superior to external cardiac massage, generating higher coronary and cerebral perfusion pressures, producing higher resuscitation and survival rates, and decreasing neurological sequels. The need for a large thoracotomy and the technical difficulties implied in its accomplishment have contributed to this technique not being used. The current study is an evaluation of a new device for minimally invasive direct cardiac massage – before cardiac surgery when ventricular fibrillation was induced in humans. After induction of the ventricular fibrillation there was a 1-min period of cardiac massage with the device. The device was positioned in the left hemithorax and the cardiac massage was begun at the frequency of 100/min. Analyzed in 10 patients were: cardiac output, myocardial blood flow, and aorta, right atrium, and coronary perfusion pressures. The aorta diastolic and coronary perfusion pressures generated by the device were very high; an increase of 27.15 ± 4.55 mmHg in the coronary perfusion pressure from the moment of the 1-min cardiopulmonary resuscitation (CPR).

In conclusion, the device increased haemodynamic parameters in 1-min CPR, before cardiac surgery.

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Timerman, S., Alves, P.M., Vieira, S. et al. Efficacy and safety of a device for minimally invasive direct cardiac masage. Crit Care 8 (Suppl 1), P295 (2004).

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