Low energy defibrillation in cardiac surgery
Hu, X.Q.; Shang, D.Y.
Zhonghua Xin Xue Guan Bing Za Zhi 9(1): 19-21
1981
ISSN/ISBN: 0253-3758 PMID: 7261880 Document Number: 170470
This is a study of the effectiveness of low energy direct cardiac defibrillation in a series of 100 consecutive cardiac operations under extracorporeal perfusion. The success rate of defibrillation was 21% with .ltoreq. 5 J, 60% with 10 J and 94% with 20 J. The success rate was not affected by the patient's age or weight, cardiac size or duration of crossclamping of the ascending aorta. It is related to the patient's preoperative pathology, the anesthesia and the extracorporeal perfusion, effectiveness of the myocardial protection, the operative procedure, effective serum K concentration, acid-base balance and the myocardial and the body temperature. The importance of avoiding coronary air embolism and supportive perfusion at the end of the operation to alleviate ischemia and tonus of the myocardium should not be neglected. For defibrillation, an energy of < 10 J may be tried and should not exceed 20 J. Specific causes should be looked for if defibrillation is not successful with low energy. Higher energy, such as .gtoreq. 50 J, is not only unnecessary but also harmful as myocardium burn could result from it.