[New approach for defibrillation after cardiac reoperation].
Cardiac reoperations are associated with several complications such as ventricular lacerations, major vessel trauma, and ventricular arrhythmias. As it is impossible to defibrillate before ending the pericardial dissection, this latter complication increases the mortality rate in the perioperative period. In those instances, the self-adhesive electrode pads for external defibrillation were proven effective for cardioversion and defibrillation, even in the presence of adherences. In our institution, these electrode pads are compulsory for all patients requiring cardiac reoperation. The apex pad covers the cardiac apex in the V5 and V6 electrode derivations, while the posterior pad is placed over the right infrascapular area, which reduces the risk of hazardous current concentration. In addition, it does not obstruct the operative site and the pads can be connected to a R2 cable adaptor compatible with regular leading defibrillating systems. The electrode pads were tested on 132 of the 508 patients (26%) requiring cardiac surgery during a 6-month period. Eighteen of these cases (14%) required one or more defibrillating during the operation. The benefits of using this system (R2 Corporation, Skokie, Ill) include: a smaller dissection, reduced blood loss, lower numbers of blood transfusions, and decreased operating time. When the electrode pads remain in place during the patient's transfer to the intensive care unit and the first hours thereafter, they can be used again this time to control arrhythmia complications after the surgery.
Houde-Pelletier
C
C
Robichaud-Ekstrand
S
S
D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D004554:Electric Countershock / Q000295:instrumentation* / Q000379:methods*; D004566:Electrodes; D006801:Humans; D007430:Intraoperative Care; D011182:Postoperative Care; D012086:Reoperation / Q000009:adverse effects*; D017180:Tachycardia, Ventricular / Q000628:therapy*
Nouvelle approche pour la défibrillation lors de réopération cardiaque.