0
Other Articles |

Ventilation and Circulation with Closed-Chest Cardiac Massage in Man

Robert J. Wilder, M.D.; Warren J. Holtey, M.D.; Torrey C. Brown; Peter Safar, M.D.
[+] Author Affiliations

Baltimore

From the departments of anesthesiology and surgery, Baltimore City Hospitals and the Johns Hopkins School of Medicine. Dr. Safar is now Chairman of the Department of Anesthesiology, University of Pittsburgh School of Medicine.


JAMA. 1961;176(7):574-576. doi:10.1001/jama.1961.03040200010003
Text Size: A A A
Published online

The author's experience has confirmed the circulatory efficacy of closed-chest cardiac massage. However, it cannot be relied upon for pulmonary ventilation. In curarized adults, with the head unsupported, rhythmic sternal pressure produced no respiratory tidal exchange, because of pharyngeal obstruction by the tongue. With the trachea intubated, sternal pressure produced an average tidal volume of 156 ml. in curarized subjects and no tidal exchange in patients with cardiac arrest. Sternal pressure failed to reoxygenate 5 of 6 hypoxic curarized subjects. Therefore, rhythmic sternal pressure must be accompanied by intermittent positive-pressure ventilation; coordinating ventilation and pressure is desirable.

REFERENCES

Kouwenhoven, W. B.; Jude, J. R.; and Knickerbocker, G. G.:  Closed-Chest Cardiac Massage , JAMA 173:1064-1067 ( (July) ) 1960;.
Safar, P.; Escarraga, L. A.; and Elam, J. O.:  Comparison of Mouth-to-Mouth and Mouth-to-Airway Methods of Artificial Respiration with Chest-Pressure Arm-Lift Methods , New Engl J Med 258:671-677 ( (April 3) ) 1958;.
Safar, P.:  Failure of Manual Respiration , J Appl Physiol 14:84-88 ( (Jan.) ) 1959;.
Safar; Escarraga, L. A.; and Chang, F.:  Upper Airway Obstruction in Unconscious Patient , J Appl Physiol 14:760-764 ( (Sept.) ) 1959;.
Nims, R. G.; Conner, E. H.; Botelho, S. Y.; and Comroe, J. H., Jr.:  Comparison of Methods for Performing Manual Artificial Respiration on Apneic Patients , J Appl Physiology 4:486-495 ( (Dec.) ) 1951;.
Mushin, W. W.; Rendell-Baker, L.; and Thompson, P. W.: Automatic Ventilation of the Lungs , Oxford: Blackwell Scientific Publications, 1959;, p. 30.
Cheng, T. O.; Godfrey, M. P.; and Shepard, R. H.:  Pulmonary Resistance and State of Inflation of Lungs in Normal Subjects and in Patients with Airway Obstruction , J Appl Physiol 14:727-732 ( (Sept.) ) 1959;.
Clements, J. A.; Finley, T. A.; and Severinghaus, J. W.: Personal communication.
Safar, P., and Aguto-Escarraga, L.:  Compliance in Apneic Anesthetized Adults , Anesthesiology 20:283-289 ( (May) -June) 1959;.
Redding, R. S., and Cozine, R. A.:  Comparison of Closed Chest and Open Chest Cardiac Massage in Dogs , Anesthesiology 22:280-285 ( (March) -April) 1961;.

First Page Preview

First page PDF preview

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

Kouwenhoven, W. B.; Jude, J. R.; and Knickerbocker, G. G.:  Closed-Chest Cardiac Massage , JAMA 173:1064-1067 ( (July) ) 1960;.
Safar, P.; Escarraga, L. A.; and Elam, J. O.:  Comparison of Mouth-to-Mouth and Mouth-to-Airway Methods of Artificial Respiration with Chest-Pressure Arm-Lift Methods , New Engl J Med 258:671-677 ( (April 3) ) 1958;.
Safar, P.:  Failure of Manual Respiration , J Appl Physiol 14:84-88 ( (Jan.) ) 1959;.
Safar; Escarraga, L. A.; and Chang, F.:  Upper Airway Obstruction in Unconscious Patient , J Appl Physiol 14:760-764 ( (Sept.) ) 1959;.
Nims, R. G.; Conner, E. H.; Botelho, S. Y.; and Comroe, J. H., Jr.:  Comparison of Methods for Performing Manual Artificial Respiration on Apneic Patients , J Appl Physiology 4:486-495 ( (Dec.) ) 1951;.
Mushin, W. W.; Rendell-Baker, L.; and Thompson, P. W.: Automatic Ventilation of the Lungs , Oxford: Blackwell Scientific Publications, 1959;, p. 30.
Cheng, T. O.; Godfrey, M. P.; and Shepard, R. H.:  Pulmonary Resistance and State of Inflation of Lungs in Normal Subjects and in Patients with Airway Obstruction , J Appl Physiol 14:727-732 ( (Sept.) ) 1959;.
Clements, J. A.; Finley, T. A.; and Severinghaus, J. W.: Personal communication.
Safar, P., and Aguto-Escarraga, L.:  Compliance in Apneic Anesthetized Adults , Anesthesiology 20:283-289 ( (May) -June) 1959;.
Redding, R. S., and Cozine, R. A.:  Comparison of Closed Chest and Open Chest Cardiac Massage in Dogs , Anesthesiology 22:280-285 ( (March) -April) 1961;.
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.