Transitory heart pacemaker for the prophylaxis of hypoxic cardiac standstill in cases of severe pulmonary insufficiency.
Patients with hypoxia due to severe pulmonary insufficiency show a tendency towards hypoxic cardiac arrest. Asystole can occur in patients during therapeutic and nursing measures such as endotracheal suction. Experience indicates that the hypoxic cardiac arrest is difficult to resuscitate. External heart massage also shows a variety of complications. We propose the appropriately timed and prophylactic use of a transitory heart pacemaker for patients with a tendency towards hypoxic cardiac arrest. Our results show that a transitory heart pacemaker is capable of producing heart contractions even in cases of the severest hypoxia, in which otherwise cardiac arrest already would have occurred. The subclavian vein is punctured, and the electrode is pushed into the right ventricle. The electrode tip is positioned accurately by means of X-ray examination, and also by monitoring the threshold of the stimulating current. We consider that the proposed method should be used in patients who would have an increased chance of survival as a result of the additional measure of using a transitory heart pacemaker in cases of pulmonary hypoxia. It would not be indicated in patients with unfavourable prognoses due to progressive changes in the lungs.
D000368:Aged; D004562:Electrocardiography; D006323:Heart Arrest / Q000517:prevention & control*; D006801:Humans; D000860:Hypoxia / Q000209:etiology; D008297:Male; D010138:Pacemaker, Artificial; D012131:Respiratory Insufficiency / Q000150:complications*; D012151:Resuscitation