title: Physiological variables during open chest cardiopulmonary resuscitation: results from a small series.
abstract: OBJECTIVE
  To evaluate the efficacy of open chest cardiac compressions for the resuscitation of pre-hospital cardiac arrest patients presenting with non-shockable rhythms on arrival at the emergency department.
  
  
  METHODS
  Prospective observational study of outcomes and physiological parameters during open chest cardiac compressions for non-traumatic pre-hospital cardiac arrest.
  
  
  METHODS
  Large accident and emergency department receiving pre-hospital cardiac arrest patients with pre-hospital advanced life support provided by ambulance service paramedics.
  
  
  METHODS
  All patients in whom open chest cardiac compressions were performed by the author (JCC) during the period from January to May 1998 (seven patients).
  
  
  METHODS
  Assessment of artificial pulse and blood pressure generated by open chest cardiac compressions, measurement of arterial blood gases, recovery of spontaneous cardiac output, recovery of spontaneous ventilatory efforts and survival to admission and to discharge.
  
  
  RESULTS
  Artificial pulse and recordable non-invasive blood pressures were generated in all patients; PO2 was physiological or supra-physiological in all patients; PCO2 was physiological or subphysiological in all patients; pH and base deficit were not corrected in the five patients with repeated samples (including two receiving 50 mEq sodium bicarbonate); three patients recovered spontaneous cardiac output (ROSC); two patients recovered spontaneous respiratory efforts (unrelated to ROSC); no patients survived to admission.
  
  
  CONCLUSIONS
  Open chest cardiac compressions provide effective perfusion, enabling correction of ventilation parameters and showing clinical signs of adequate perfusion. However, acidosis was not corrected and the use of 50 mEq sodium bicarbonate was ineffective.
authors.affiliation: Emergency Department, North Staffordshire Hospital, Stoke on Trent. designworks@fsbdial.co.uk
authors.forename: J
authors.initials: J
authors.lastname: Calinas-Correia
authors.forename: I
authors.initials: I
authors.lastname: Phair
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation; D004632:Emergency Medical Services; D004739:England; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013908:Thoracotomy; D016896:Treatment Outcome