Objective: Recently, a new device for minimally invasive direct cardiac massage (MIDCM) has been developed. In animal models of cardiopulmonary resuscitation MIDCM has been shown to provide better organ perfusion than external chest compressions (ECC) massage. Since this device has been developed to improve cardiopulmonary resuscitation in humans, its use must be simple. Thus, we measured the time required for the insertion of the MIDCM device on human cadavers.
Design: After a 1 h theoretical course, physicians and surgeons were asked to use the MIDCM device on human cadavers. We measured the time from the cutaneous incision to the first direct cardiac compression.
Main Results: The mean time required for the insertion of the MIDCM device was 16+/-11 s (range 8-58 s). The insertion time required for each group of physicians were as follows, 15+/-8 s for anaesthesiologists (range 8-28 s), 11+/-2 s for cardiac surgeons (range 9-15 s), 42+/-14 s for cardiologists (range 27-58 s), and 12+/-4 s for intensive care physicians (range 8-18). All participants compared the insertion of the MIDCM device favorably with the insertion of a chest drain.
Conclusion: The MIDCM device can be placed in a few seconds in human cadavers by physicians familiar with chest drain insertion. Theoretical course and training with the device may be useful especially for those who are not familiar with chest drain insertion.
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http://dx.doi.org/10.1016/s0300-9572(01)00443-9 | DOI Listing |
Resuscitation
December 2002
University of Alabama at Birmingham, 1530 3rd Ave So., Volker Hall B140, 35294-0019, USA.
Objective: This study examined (1) the defibrillation efficacy of using a minimally invasive direct cardiac massage (MID-CM) device as one electrode of the defibrillation electrical circuit and (2) the effect on external defibrillation of defibrillating when the MID-CM device is in place and a pneumothorax is present.
Methods: Part 1: in seven pigs, defibrillation thresholds (DFTs) were determined with a truncated exponential biphasic waveform. DFTs were determined for five electrode configurations: standard transthoracic defibrillation with electrodes on the left and right chest walls (1), with the MID-CM as one of the defibrillation electrodes pressed gently (2) or firmly (3) against the heart with the right chest wall patch as the second electrode, the same as (1) with the MID-CM device in place and the lungs at end-inspiration (4) or at end-expiration (5).
Resuscitation
January 2002
Department of Anesthesiology and Surgical Intensive Care and Emergency Medicine, CHU de Caen, France.
Objective: Recently, a new device for minimally invasive direct cardiac massage (MIDCM) has been developed. In animal models of cardiopulmonary resuscitation MIDCM has been shown to provide better organ perfusion than external chest compressions (ECC) massage. Since this device has been developed to improve cardiopulmonary resuscitation in humans, its use must be simple.
View Article and Find Full Text PDFResuscitation
September 2001
SAMU de PARIS and Department of Anesthesiology, Necker-Enfants Malades Hospital, 149 rue de Sèvres, 75743 Paris Cedex 15, France.
Background: Internal cardiac compressions are more efficient than closed chest compressions (CCC) in cardiac arrest (CA).
Aim Of The Study: To evaluate the prehospital feasibility of performing a new method of minimally invasive direct cardiac massage (MID-CM TheraCardia Inc.).
Resuscitation
June 1997
Safar Center for Resuscitation Research, University of Pittsburgh, PA 15260, USA.
Standard external cardiopulmonary resuscitation (SECPR) frequently produces very low perfusion pressures, which are inadequate to achieve restoration of spontaneous circulation (ROSC) and intact survival, particularly when the heart is diseased. Ultra-advanced life support (UALS) techniques may allow support of vital organ systems until either the heart recovers or cardiac repair or replacement is performed. Closed-chest emergency cardiopulmonary bypass (CPB) provides control of blood flow, pressure, composition and temperature, but has so far been applied relatively late.
View Article and Find Full Text PDFResuscitation
June 1995
Department of Surgery, Temple University Health Science Center, Philadelphia, PA 19140, USA.
Background: Open-chest cardiac massage (OC-CM) provides higher blood pressure and flow than closed-chest compression and may improve the probability of successful resuscitation from cardiac arrest. Its clinical use has been limited by its requirement for a major thoracotomy. The present pilot study tested the technical feasibility of performing effective direct cardiac massage without a major thoracic incision, by using a simple, manually-powered plunger-like device, inserted through a small thoracic incision, to cyclically compress the cardiac ventricles.
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