ABSTRACT
The surgeon is most likely to encounter a patient who has sustained a cardiac arrest in a hospital environment, where adequate monitoring will be in place and support personnel competent to initiate cardiopulmonary resuscitation (CPR) and advanced cardiovascular life support. Complications of CPR will be determined by the length of time to return of spontaneous circulation and the mode of delivery chosen for the cardiac compressions. Most physiologists favor the thoracic pump model of CPR. Most complications after closed-chest CPR are related to thoracic wall damage and include rib or sternal fractures and costochondral separation. The most serious complication of either closed-chest or open-chest CPR, of course, is failure to resuscitate. The primary goal of management after CPR is reestablishing global and regional perfusion of tissues. Cardiac injuries can occur during open cardiac massage. Perforation of the right ventricle is a serious complication and is usually caused by incorrectly applied cardiac compression.
