Pulseless electrical activity surgery: Difference between revisions
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==Overview== | ==Overview== | ||
External and internal pacing have not been shown to improve outcome and are not recommended. There may be capture of the signals, but there is no improvement in contractility. In appropriate patients with pulseless electrical activity (PEA), pericardiocentesis and emergent cardiac surgery may be lifesaving procedures. When adequate expertise is available, thoracotomy can be performed in refractory cases, if the patient had chest trauma | External and internal pacing have not been shown to improve outcome and are not recommended. There may be capture of the signals, but there is no improvement in contractility. In appropriate patients with pulseless electrical activity (PEA), pericardiocentesis and emergent cardiac surgery may be lifesaving procedures. When adequate expertise is available, thoracotomy can be performed in refractory cases, if the patient had chest trauma. Circulatory assistance (e.g., intra-aortic balloon pump, extracorporeal membrane oxygenation, cardiopulmonary bypass, and ventricular assist device), can be used to manage patients with near pulseless electrical activity or a very low-output state.The chances of a successful outcome depend on a very coordinated resuscitation process where specific person responsible for specific steps and a good team leader should be available. <br /> | ||
The chances of a successful outcome depend on a very coordinated resuscitation process | |||
== Surgery == | == Surgery == | ||
The following can be used in selected patients: | |||
* Pericardiocentesis | |||
* Emergent cardiac surgery | |||
* Thoracotomy | |||
Patients with near pulseless electrical activity or a very low-output state can be managed with: | |||
* Circulatory assistance | |||
* Intra-aortic balloon pump | |||
* Extracorporeal membrane oxygenation | |||
* Cardiopulmonary bypass | |||
* Ventricular assist device | |||
Revision as of 20:25, 1 April 2020
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Resident Survival Guide |
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Pulseless electrical activity Microchapters |
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Differentiating Pulseless Electrical Activity from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Pulseless electrical activity surgery On the Web |
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American Roentgen Ray Society Images of Pulseless electrical activity surgery |
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Directions to Hospitals Treating Pulseless electrical activity |
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Risk calculators and risk factors for Pulseless electrical activity surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
External and internal pacing have not been shown to improve outcome and are not recommended. There may be capture of the signals, but there is no improvement in contractility. In appropriate patients with pulseless electrical activity (PEA), pericardiocentesis and emergent cardiac surgery may be lifesaving procedures. When adequate expertise is available, thoracotomy can be performed in refractory cases, if the patient had chest trauma. Circulatory assistance (e.g., intra-aortic balloon pump, extracorporeal membrane oxygenation, cardiopulmonary bypass, and ventricular assist device), can be used to manage patients with near pulseless electrical activity or a very low-output state.The chances of a successful outcome depend on a very coordinated resuscitation process where specific person responsible for specific steps and a good team leader should be available.
Surgery
The following can be used in selected patients:
- Pericardiocentesis
- Emergent cardiac surgery
- Thoracotomy
Patients with near pulseless electrical activity or a very low-output state can be managed with:
- Circulatory assistance
- Intra-aortic balloon pump
- Extracorporeal membrane oxygenation
- Cardiopulmonary bypass
- Ventricular assist device