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domingo, 19 de mayo de 2019

Chest compressions in traumatic cardiac arrest

St. Emlyn´s - Simon Carley - May 19, 2019 
"This is a question that we’ve addressed on the blog before and the evidence has been a little conflicting. From a pathophysiological perspective the logic of using closed chest compressions in a patient who has no circulating volume is clearly pointless. In order for CCC to work, then the patient has to have an intravascular volume to pump around the circulation. However, that’s just a pathophysiological argument and to date there has been little evidence to support it. 
This week there is a paper published which, although an experimental model in pigs, might help enlighten the debate​. 
I actually saw this data at a recent conference but it was (rightly) embargoed and so it’s great to see it in e-print format. The abstract is below, but as always please read the paper yourself and make your own mind up.... 
The bottom line 
If you think that your patient is in hypovolaemic traumatic cardiac arrest then CCC is unlikely to be helpful and may be harmful (but exclude other causes before you abandon them)."