Abstract
Cardiopulmonary resuscitation (CPR) in a patient with multiple injuries involves a different approach than in a nontrauma patient. Although the basic principles are the same as dealt with in other chapters of this book, CPR in the trauma victim has to address prevention of cardiopulmonary failure from problems exclusive to the injured patient. This chapter concentrates on these issues and highlights some of the recent developments in the field.
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References
Cannon WB, Faser J, Cowell EM. The preventive treatment of wound shock. JAMA 1918; 47:618.
Kaweski SM, Sise MJ, Virgilio RW. The effect of prehospital fluids on survival in trauma patients. J Trauma 1990; 30:1215–1219.
Bickell WH, Wall MJ Jr, Pepe PE, et al. Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med 1994; 331:1105–1109.
Gross D, Landau EH, Assalia A, Krausz MM. Is hypertonic saline resuscitation safe in “uncontrolled” hemorrhagic shock? J Trauma 1988; 28:751–756.
Bickell WH, Bruttig SP, Wade CE. Hemodynamic response to abdominal aortotomy in the anesthetized swine. Circ Shock 1989; 28:321–332.
Krausz MM, Horn Y, Gross D. The combined effect of small volume hypertonic saline and normal saline solutions in uncontrolled hemorrhagic shock. Surg Gynecol Obstet. 1992; 174:363–368.
Kowalenko T, Stern SA, Dronen SC, Wang X. Improved outcome with hypotensive resuscitation of uncontrolled hemorrhagic shock in a swine model. J Trauma 1992; 33:349–353.
Gross D, Landau EH, Klin B, Krausz MM. Treatment of uncontrolled hemorrhagic shock with hypertonic saline solution. Surg Gynecol Obstet 1990; 170:106–112.
Bickell WH, Bruttig SP, Millnamow GA, O’Benar J, Wade CE. The detrimental effects of intravenous crystalloid after aortotomy in swine. Surgery 1991; 110:529–536.
Krausz MM, Bar-Ziv M, Rabinovici R, Gross D. “Scoop and run” or stabilize hemorrhagic shock with normal saline or small-volume hypertonic saline? J Trauma 1992; 33:6–10.
Stern SA, Dronen SC, Birrer P, Wang X. The effect of blood pressure on hemorrhage volume and survival in a near-fatal hemorrhage model incorporating a vascular injury. Ann Emerg Med 1993; 22:155–163.
Matsuoka T, Hildreth J, Wisner DH. Liver injury as a model of uncontrolled hemorrhagic shock: resuscitation with different hypertonic regimens. J Trauma 1995; 39:674–680.
Matsuoka T, Hildreth J, Wisner DH. Uncontrolled hemorrhage from parenchymal injury: is resuscitation helpful? J Trauma 1996; 40:915–922.
Solomonov E, Hirsh M, Yahiya A, Krausz MM. The effect of vigorous fluid resuscitation in uncontrolled hemorrhagic shock following massive splenic injury. Crit Care Med 2000; 28:749–754.
Krausz MM, Bashenko Y, Hirsh M. Crystalloid or colloid resuscitation of uncontrolled hemorrhagic shock after moderate splenic injury. Shock 2000; 13:230–235.
Krausz MM, Bashenko Y, Hirsh M. Crystalloid and colloid resuscitation of uncontrolled hemorrhagic shock following massive splenic injury. Shock 2001; 16:383–388.
Abu-Hatoum O, Bashenko Y, Hirsh M, Krausz MM. Continuous fluid resuscitation and splenectomy for treatment of uncontrolled hemorrhagic shock after massive splenic injury. J Trauma 2002; 52:253–258.
Kaweski SM, Sise MJ, Virgilio RW. The effect of prehospital fluids on survival in trauma patients. J Trauma 1990; 30:1215–1219.
Babbs CF, Thelander K, Engoren M, Severyn F, Fenn-Buderer N, DeFrank M. Theoretically optimal duty cycles for chest and abdominal compression during external cardiopulmonary resuscitation: Cardiac output, coronary blood flow, and blood gases during open-chest standard and compression-active-decompression cardiopulmonary resuscitation. Resuscitation 2002; 55:309–316.
Sanders AB, Kern KB, Ewy GA, Atlas M, Bailey L. Improved resuscitation from cardiac arrest with open-chest massage. Ann Emerg Med 1984; 13(Pt 1):672–675.
Rieder CF, Crawford BG, Iliopoulos JI, Thomas JH, Pierce GE, Hermreck AS. A study of the techniques of cardiac massage with the abdomen open. Surgery 1985; 98:824–830.
Ivatury RR. Emergency Room Thoracotomy. In: Ivatury RR, Cayten CG, eds. The Textbook of Penetrating Trauma. Baltimore: Williams & Wilkins, 1996.
Ivatury RR, Rohman M. Emergency department throacotomy for trauma: a collective review. Resuscitation 1987; 15:23.
Boyd M, Vaneck VW, Bourguet CC. Emergency room thoracotomy: when is it indicated? J Trauma 1992; 33:714–721.
Rhee PM, Jordan MR, Rich N. Survival after emergency department thoracotomy: review of published data from the past 25 years. J Am Coll Surg 2000; 190:288–298.
Ladd AP, Gomez GA, Jacobson LE, Broadie TA, Scherer LR III, Solotkin KC. Emergency room thoracotomy: updated guidelines for a level I trauma center. Am Surg 2002; 68:421–424.
Wade CEJ, Grady JJ, Fabian T, Younas RN, Kramer GC. Efficacy of hypertonic 7.5% saline and 6% dextran-70 in treating trauma: a meta-analysis of controlled clinical studies. Surgery 1997; 122:609–616.
Holcroft JW, Vassar MJ, Turner JE, Derlet RW, Kramer GC. 3% NaCl and 7.5% NaCl/dextran 70 in the resuscitation of severely injured patients. Ann Surg 1987; 206:279–288.
Vassar MJ, Fischer RP, O’Brien PE, et al. A multicenter trial for resuscitation of injured patients with 7.5% sodium chloride. Arch Surg 1993; 128:1003–1013.
Krausz MM. Controversies in shock research: hypertonic resuscitation pros and cons. Shock 1995; 3: 69–72.
Dronen SC, Stern SA, Wang X, Stanley M. A comparison of the response of near-fatal acute hemorrhage models with and without a vascular injury to rapid volume expansion. Am J Emerg Med 1993; 11:331–335.
Sindlinger JF, Soucy DM, Greene SP, Barber AE, Illner H, Shires T. The effects of isotonic saline volume resuscitation in uncontrolled hemorrhage. Surg Gynecol Obstet 1993; 177:545–550.
Krausz MM, David M, Amstislavsky T. Hypertonic saline treatment of uncontrolled hemorrhagic shock in awake rats. Shock 1994; 2:267–270.
Bunn F, Roberts I, Tasker R, Akpa E. Hypertonic versus isotonic crystalloid for fluid resuscitation in critically ill patients. Cochrane Database Syst Rev 2002; (1):CD002045.
Novak L, Shackford SR, Bourguignon P, et al. Comparison of standard and alternative prehospital resuscitation in pressure driven hemorrhagic shock and head injury. J Trauma. 1999; 47:834–844.
Doyle JA, Davis DP, Hoyt DB. The use of hypertonic saline in the treatment of traumatic brain injury. J Trauma 2001; 50:367–83.
Shackford S. Effect of small-volume resuscitation on intracranial pressure and related cerebral variables. J Trauma 1997; 42(Suppl):S48–S53.
Ducey J, Lamiell J, Gueller G. Cerebral electrophysiologic effects of resuscitation with hypertonic saline-dextran after hemorrhage. Crit Care Med 1990; 18:744–749.
Gemma M, Cozzi S, Piccoli S, Magrin S, De Vitis A, Cenzato M. Hypertonic saline fluid therapy following brain stem trauma. J Neurosurg Anesthesiol 1996; 8:137–141.
Qureshi A, Wilson D, Traystman R. Treatment of elevated intracranial pressure in experimental intracerebral hemorrhage: comparison between mannitol and hypertonic saline. Neurosurgery 1999; 44:1055–1063.
Suarez J, Qureshi A, Bhardwaj A, et al. Treatment of refractory intracranial hypertension with 23.4% saline. Crit Care Med 1998; 26:1118–1122.
Corso CO, Okamoto S, Leiderer R, Messmer K. Resuscitation with hypertonic saline dextran reduces endothelial cell swelling and improves hepatic microvascular perfusion and function after hemorrhagic shock. J Surg Res 998; 80:210–220.
Cudd TA, Purinton S, Patel NC, Wood CE. Cardiovascular, adrenocorticotropin, and cortisol responses to hypertonic saline in euvolemic sheep are altered by prostaglandin synthase inhibition. Shock 1998; 10: 32–36.
Corso CO, Okamoto S, Reuttinger D, Messmer K. Hypertonic saline dextran attenuates leukocyte accumulation in the liver after hemorrhagic shock and resuscitation. J Trauma 1999; 46:417–423.
Angle N, Hoyt DB, Cabello-Passini R, Herdon-Remelius C, Loomis W, Junger WG. Hypertonic saline resuscitation reduces neutrophil margination by suppressing neutrophil L selectin expression. J Trauma 1998; 45:7–13.
Angle N, Hoyt DB, Coimbra R, et al. Hypertonic saline resuscitation diminishes lung injury by suppressing neutrophil activation after hemorrhagic shock. Shock 1998; 9:164–170.
Junger WG, Hoyt DB, Davis RE, et al. Hypertonicity regulates the function of human neutrophils by modulating chemoattractant receptor signaling and activating mitogen-activated protein kinase p38. J Clin Invest 1998; 101:2768–2779.
Patrick DA, Moore EE, Offner PJ, Johnson JL, Tamura DY, Silliman CC. Hypertonic saline activates lipid-primed human neutrophils for enhanced elastase release. J Trauma 1998; 44:592–598.
Coimbra R, Junger WG, Hoyt DB, Liu FC, Loomis WH, Evers MF. Hypertonic saline resuscitation restores hemorrhage-induced immunosuppression by decreasing prostaglandin E2 and interleukin-4 production. J Surg Res 1996; 64:203–209.
Tokyay R, Zeigler ST, Kramer GC, et al. Effects of hypertonic saline dextran resuscitation on oxygen delivery, oxygen consumption, and lipid peroxidation after burn injury. J Trauma 1992; 32:704–713.
Coimbra R, Hoyt DB, Junger WG, et al. Hypertonic saline resuscitation decreases susceptibility to sepsis after hemorrhagic shock. J Trauma 1997; 42:602–607.
Worthley LI, Cooper DJ, Jones N. Treatment of resistant intracranial hypertension with hypertonic saline. Report of two cases. J Neurosurg 1988; 68:478–481.
Einhaus S, Croce M, Watridge C, Lowery R, Fabian T. The use of hypertonic saline for the treatment of increased intracranial pressure. J Tenn Med Assoc 1996; 89:81–82.
Schatzmann C, Heissler H, K^nig K, et al. Treatment of elevated intracranial pressure by infusions of 10% saline in severely head injured patients. Acta Neurochir Suppl (Wien) 1998; 71:31–33.
Simma B, Burger R, Falk M, Sacher P, Fanconi S. A prospective, randomized, and controlled study of fluid management in children with severe head injury: lactated Ringer’s solution versus hypertonic saline. Crit Care Med 1998; 26:1270.
Horn P, Meunch E, Vajkoczy P, et al. Hypertonic saline solution for control of elevated intracranial pressure in patients with exhausted response to mannitol and barbiturates. Neurol Res 1999; 21:758–764.
Vassar MJ, Perry CA, Gannaway WL, Holcroft JW. 7.5% sodium chloride/dextran for resuscitation of trauma patients undergoing helicopter transport. Arch Surg 1991; 126:1065–1072.
Vassar M, Perry C, Holcroft J. Prehospital resuscitation of hypotensive trauma patients with 7.5% NaCl versus 7.5% NaCl with added dextran: a controlled trial. J Trauma 1993; 34:622–632.
Stone HH, Strom PR, Mullins RJ. Management of the major coagulopathy with onset during laparotomy. Ann Surg 1983; 197:532–535.
Rotondo MF, Schwab CW, McGonigal MD, et al. Damage control: an approach for improved survival in exsanguinating penetrating abdominal injury. J Trauma 1993; 35:375–383.
Burch JM, Ortiz VB, Richardson RJ, et al. Abbreviated laparotomy and planned re-operation for critically injured patients. Ann Surg 1992; 215:476–484.
Moore EE. Staged laparotomy for the hypothermia, acidosis and coagulopathy syndrome. Am J Surg 1996; 172:405–410.
Shapiro MB, Jenkins DH, Schwab CW, Rotondo MF. Damage control: collective review. J Trauma 2000; 49:969–978.
Vargo DJ, Battistella FD. Abbreviated thoracotomy and temporary chest closure: an application of damage control after thoracic trauma. ArchSurg 2001; 136:21–24.
Johnon JW, Gracias VH, Schwab CW, et al. Evolution in damage control for exsanguinating penetrating abdominal injury. J Trauma 2001; 51:261–269.
Asensio JA, McDuffie L, Petrone P, et al. Reliable variables in the exsanguinated patient which indicate damage control and predict outcome. Am J Surg 2001; 182:743–751.
Hoey BA, Schwab CW. Damage control surgery. Scand J Surg 2002; 91:92–103.
Barker DE, Kaufman HJ, Smith LA, Ciraulo DL, Richart CL, Burns RP. Vacuum pack technique of temporary abdominal closure: a 7-year experience with 112 patients. J Trauma 2000; 48:201–206.
Miller PR, Thompson JT, Faler BJ, Meredith JW, Chang MC. Late fascial closure in lieu of ventral hernia: the next step in open abdomen management. J Trauma 2002; 53:843–849.
Garner GB, Ware DN, Cocanour CS, et al. Vacuum-assisted wound closure provides early fascial reapproximation in trauma patients with open abdomens. Am J Surg 2001; 182:630–638.
Markley MA, Mantor PC, Letton RW, Tuggle DW. Pediatric vacuum packing wound closure for damage-control laparotomy. J Pediatr Surg 2002; 37:512–514.
Ivatury RR, Diebel L, Porter JM et al. Intra-abdominal hypertension and the abdominal compartment syndrome. Surg Clin North Am 1997; 77:783–800.
Ivatury RR, Porter JM, Simon RJ et al. Intra-abdominal hypertension after life threatening abdominal trauma: incidence, prophylaxis and clinical relevance to gastric mucosal pH and abdominal compartment syndrome. J Trauma 1998; 44:1016–1021.
Saggi BH, Sugerman HJ, Ivatury RR et al. Abdominal compartment syndrome. J Trauma 1998; 45: 597–609.
Schein M, Wittmann DH, Aprahamian CC et al. The abdominal compartment syndrome: the physiological and clinical consequences of elevated intra-abdominal pressure. J Amer Coll Surg 1995; 180:747–753.
Burch JM, Moore EE, Moore FA et al. The abdominal compartment syndrome. Surg Clin North Amer 1996; 76:833–842.
Sugerman HJ, Windsor A, Bessos M et al. Intra-abdominal pressure, sagittal abdominal diameter, and obesity comorbidity. J Intern Med 1997; 241:71–79.
Morris JA Jr, Eddy VA, Blinman TA et al. The staged celiotomy for trauma. Issues in unpacking and reconstruction. Ann Surg 1993; 217:576–586.
Loi P, De Backer D, Vincent JL. Abdominal compartment syndrome. Acta Chir Belg 2001; 101: 59–64.
Barnes GE, Laine GA, Gaim PY, et al. Cardiovascular responses to elevation of intra-abdominal hydrostatic pressure. Am J Physiol 1985; 248:R208–R213.
Sugrue M, Jones F, Janjua KJ, Deane SA, Bristow P, Hillman K. Temporary abdominal closure: a prospective evaluation of its effects on renal and respiratory physiology. J Trauma 1998; 45;914–921.
Caldwell CB, Ricotta JJ. Changes in visceral blood flow with elevated intra-abdominal pressure. J Surg Res 1987; 43:14–20.
Diebel LN, Wilson RF, Dulchavshy SA. Effect on increased intra-abdominal pressure on hepatic arterial, portal venous, and hepatic microcirculatory blood flow. J Trauma 1992; 33:279–283.
Diebel LN, Dulchavshy SA, Wilson RF. Effect on increased intra-abdominal pressure on mesenteric arterial and intestinal mucosal blood flow. J Trauma 1992; 33:45–49.
Bongard F, Pianim N, Dubecz S, Klein S. Adverse consequences of increased intra-abdominal pressure on bowel tissue oxygenation. J Trauma 1995; 39:519–525.
Chang MC, Miller PR, D’Agostino R Jr, Meredith JW. Effects of abdominal decompression on cardiopulmonary function and visceral perfusion in patients with intra-abdominal hypertension. J of Trauma 1998; 44:440–445.
Rezende-Neto JB, Moore EE, Melo De Andrade MV, et al. Systemic inflammatory response secondary to abdominal compartment syndrome: stage for multiple organ failure. J. Trauma 2002; 53:1121–1128.
Doty JM, Oda J, Ivatury RR, et al. The effects of hemodynamic shock and increased intra-abdominal pressure on bacterial translocation. J Trauma 2002; 52:13–17.
Oda J, Ivatury RR, Blocher CR, Malhotra AJ, Sugerman HJ. Amplified cytokine response and lung injury by sequential hemorrhagic shock and abdominal compartment syndrome in a laboratory model of ischemia-reperfusion. J Trauma 2002; 52:625–631.
Ivatury RR, Cayten CG. (eds.) The Textbook of Penetrating Trauma. Baltimore, MD: Williams & Wilkens, 1996.
Josephs LG, Este-McDonald JR, Birkett DH et al. Diagnostic laparoscopy increases intracranial pressure. J Trauma 1994; 36:815–819.
Bloomfield GL, Ridings PC, Blocher CR, Marmarou A, Sugerman HJ. Effects of increased intra-abdominal pressure upon intracranial and cerebral perfusion pressure before and after volume expansion. J Trauma 1996; 40: 936–943.
Bloomfield GL, Ridings PC, Blocher CR, Marmarou A, Sugerman HJ. A proposed relationship between increased intra-abdominal, intra-thoracic, and intracranial pressure. Crit Care Med 1997; 25:496–503.
Ertel W, Oberholzer A, Platz A, et al. Incidence of Abdominal compartment syndrome after “damage-control” laparotomy in 311 patients with severe abdominal and/or pelvic trauma. Crit Care Med 2000; 28:1747–1753.
Meldrum DR, Moore FA, Moore EE, Franciose RJ, Sauaia A, Burch JM. Prospective characterization and selective management of the abdominal compartment syndrome. Am J Surg 1997; 174:667–672.
Hong JJ, Cohn SM, Perez JM, Dolich MO, Brown M, McKenney MG. Prospective study of the incidence and outcome of intra-abdominal hypertension and the abdominal compartment syndrome. Br J Surg 2002; 89:591–596.
Maxwell RA, Fabian TC, Croce MA et al. Secondary abdominal compartment syndrome: an underappreciated manifestation of severe hemorrhagic shock. J Trauma 1999; 47:995–999.
Biffl WL, Moore EE, Burch JM, Offner PJ, Franciose RJ, Johnson JL. Secondary abdominal compartment syndrome is a highly lethal event. Am J Surg 2001; 182:645–648.
Balogh Z, McKinley BA, Cocanour CS, Kozar RA, Holcomb JB, Ware DN, Moore FA. Secondary abdominal compartment syndrome is an elusive early complication of traumatic shock resuscitation. Am J Surg 2002; 184:538–543.
Sugrue M, Jones F, Lee A, Buist MD, Deane S, Bauman A, Hillman K, Intraabdominal pressure and gastric intramucosal pH: is there an association? World J Surg 1996; 20:988–991.
Friedlander MH, Simon RJ, Ivatury R, DiRaimo R, Machiedo GW. Effect of hemorrhage on superior mesenteric artery flow during increased intra-abdominal pressures. J Trauma 1998; 45:433–439.
Simon RJ, Friedlander MH, Ivatury RR, DiRaimo R, Machiedo GW. Haemorrhage lowers the threshold for intra-abdominal hypertension-induced pulmonary dysfunction. J Trauma 1997; 42:398–403.
Raeburn CD, Moore EE, Biffl WL, et al. The abdominal compartment syndrome is a morbid complication of postinjury damage control surgery. Am J Surg 2001; 182:542–546.
Mayberry JC, Mullins RJ, Crass RA et al. Prevention of abdominal compartment syndrome by absorbable mesh prosthesis closure. Arch Surg 1997; 132:957–961.
Mayberry JC. Prevention of the abdominal compartment syndrome. Lancet 1999; 354:1749–1750.
Offner PJ, de Souza AL, Moore EE, et al. Avoidance of abdominal compartment syndrome in damage-control laparotomy after trauma. Arch Surg 2001; 136:676–681.
Latenser BA, Kowal-Vern A, Kimball D, Chakrin A, Dujovny N. A pilot study comparing percutaneous decompression with decompressive laparotomy for acute abdominal compartment syndrome in thermal injury. J Burn Care Rehabil. 2002; 23:190–195.
Corcos AC, Sherman HF. Percutaneous treatment of secondary abdominal compartment syndrome. J Trauma 2001; 51:1062–1064.
Yang EY, Marder SR, Hastings G, Knudson MM. The abdominal compartment syndrome complicating nonoperative management of major blunt liver injuries: recognition and treatment using multimodality therapy. J Trauma 2002; 52:982–986.
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Ivatury, R.R., Ward, K.R. (2005). Cardiopulmonary Resuscitation in Trauma. In: Ornato, J.P., Peberdy, M.A. (eds) Cardiopulmonary Resuscitation. Contemporary Cardiology. Humana Press. https://doi.org/10.1385/1-59259-814-5:455
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DOI: https://doi.org/10.1385/1-59259-814-5:455
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