Cardiac Arrest Post Cardiac Surgery
Last modified: 02 September 2021, 11:50:14 AM AEST
Prognosis1 / 5
- better than traditional in-hospital arrests (79% vs 18%)
- Main causes of non-VF/VT arrest
- Tamponade
- Hypovolaemia
- Tension pneumothorax
Complications2 / 5
- myocardial contusions / rupture
Management3 / 5
- follow CALS (Cardiac Advanced Life Support) protocol
- Resternotomy within 5 minutes
- This is indicated until 10 days postop
- after that, significant adhesions to mediastinal structures
- Caution full-dose adrenaline
- Defer ECC
- VF/VT = Given 3-stacked DC shocks
- Asystole = Optimise pacing
- DDD at rate 80-100 with maximum stimulation threshold
- Then start ECC and continue ECC until resternotomy
- Internal cardiac massage
- trained personnel
- risk of cardiac and graft injury
- 2-handed ICM = flat palms and straight fingers
- internal defibrillation
Anaesthetic considerations4 / 5
- Pre-op
- Intra-op
- Post-op