Internal cardiac massage in dogs: a new technique proposition for emergency pericardiotomy - ligament traction

PURPOSE: Describe a technique of emergency pericardiotomy, named as Ligament Traction (LT), to reduce the necessary time to begin the Internal Cardiac Massage. To perform the ICM an emergency toracotomy and pericardiotomy are necessary, both in remote time. The technique usually employed is the "T" pericardiotomy, whose execution depends on the apprehension of the pericardium with an Allis forceps. This apprehension is difficult and complicates the reanimation of the patient METHODS: Twenty canine corpses were divided into two groups: Group I - "T" pericardiotomy (n=10), and Group II - the LT technique (n=10). The LT consisted on the traction of the pericardiumphrenic ligament and the section of the pericardium next to its apex. The incision was elongated with the introduction of the fingers, also allowing the positioning of the heart in the hand of the operator and the immediate beginning of the ICM. RESULTS: Group I presented an execution period of 21.79 ± 0.88 second, and Group II of 8.58 ± 1.38, with p<0.0001 (highly expressive). CONCLUSION: The technique of pericardiotomy by Ligament Traction concur to outliving, because it avoids a larger time of cerebral ischemia, due to the early beginning of the circulation.

Cardiopulmonary arrest; Cardiopulmonary Resuscitation; Pericardium

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