Long-term survival with open-chest cardiac massage after ineffective closed-chest compression in a canine preparation

K. B. Kern, A. B. Sanders, S. F. Badylak, W. Janas, A. B. Carter, W. A. Tacker, G. A. Ewy

Research output: Contribution to journalArticlepeer-review

74 Scopus citations


The ultimate goal of cardiopulmonary resuscitation (CPR) is long-term, neurologically intact survival. This study examined whether open-chest cardiac massage could improve 7 day survival and neurologic function when instituted after the failure of standard closed-chest compression CPR. Twenty-nine mongrel dogs were anesthetized and then instrumented with catheters to monitor right atrial and ascending aortic pressures. Ventricular fibrillation was induced and after 3 min standard CPR was begun. Standard CPR was performed with a Thumper programmed for 2 inch chest compressions at 60/min with a 50% duty cycle. External defibrillation was attempted twice after 15 min of ventricular fibrillation. Unsuccessfully defibrillated animals were randomly assigned to either an additional 2 min of continued closed-chest compressions, or 2 min of open-chest cardiac massage. All animals underwent a period of advanced cardiac life support and were followed until they were resuscitated or died. Follow-up care, including scoring of neurologic deficit, was performed for 7 days. In dogs receiving open-chest cardiac massage there was significantly more immediate resuscitation success (14/14 vs 5/14; p < .005), 24 hr survival (12/14 vs 4/14; p < .005), and 7 day survival (11/14 vs 4/14; p < .02) than in those receiving continued closed-chest compression. Open-chest cardiac massage significantly improved long-term outcome when instituted after 15 min of ineffective closed-chest compression.

Original languageEnglish
Pages (from-to)498-503
Number of pages6
Issue number2
StatePublished - 1987
Externally publishedYes


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