[HSF] Cardiac arrest after redo CABG in a young patient

[Nasser F. Abou'Seada]

I thought that was ABC

NFA

On Dec 4, 2007 4:44 PM, Edward Bender <ebender001 at charter.net> wrote:

> I would bet that this was right coronary graft occlusion.  Not
> necessarily due to the anastamosis, but perhaps due to mediastinal
> compression in the very obese.  I think this sort of event demands re-
> opening the sternum as the first act after you have arrived in the
> icu.  Let the other people do closed chest CPR while you are on your
> way to the hospital.  On my cell phone, in the car, I tell the ICU
> personnel to have the re-opening tray at the bedside, open with a pair
> of gloves ready for me to put on.  I have not saved many like this,
> but I have saved some.  Especially in morbidly obese patients, open
> cardiac compression is better than closed chest compressions.  You
> also get to definitively rule out tamponade.
>
> Ed Bender, MD
>
>
> On Dec 3, 2007, at 10:41 PM, zzhoumd at pol.net wrote:
>
> > To forum members,
> >
> > This weekend I was on call. One of my partners patients developed
> > cardiac arrest. He is only 57 year old had redo CABGx5 4 days ago.
> > Weight about 300LB. After 30 minutes CPR, he is still asystole.
> > Considering his young age, I placed him on ECMO. I thought about
> > BiVAD, but I just do not know if his brain will come back. Just
> > wonder if anybody will do anything different. I did not reexplore
> > him as TEE show no tampnade and he has no more conduit.
> >
> > Thanks!
> >
> > Z Zhou
> > Sent via BlackBerry by AT&T
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