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Should adrenaline be routinely used by the resuscitation team if a patient suffers a cardiac arrest shortly after cardiac surgery?

Leiden University Medical Center, Department of Cardio-thoracic Surgery, Albinusdreef 2, 2333 AC Leiden, NL

Should adrenaline be routinely used by the resuscitation team if a patient suffers a cardiac arrest shortly after cardiac surgery?

Most of the time emergency re-thoracotomy is the effective method to solve the problem causing a circulatory arrest after cardiac surgery. The authors state correctly that there is no evidence for injecting adrenaline to treat the loss of circulation [1]. If the cause of the cardiac arrest is not resolved by the re-thoracotomy, the surgeon can very easily inject adrenaline directly into the left ventricle of the heart. Moreover, this method in combination with internal cardiac massage guarantees that the adrenaline reaches the coronary circulation in contrast to an intravenous injection of adrenaline in the circumstances of a circulatory arrest.

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1. Tsagkataki M, Levine A, Strang T, Dunning J. Should adrenaline be routinely used by the resuscitation team if a patient suffers a cardiac arrest shortly after cardiac surgery? Interact CardioVasc Thorac Surg 2008;7:457–463.[Abstract/Free Full Text]

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