Summary
On the basis of six selected cases from a larger clinical series, a method of management after cardiac arrest has been described. Fatalities are primarily related to central nervous system damage. Clinical manifestations of this damage present as neurological sequelae such as hyperpyrexia, persisting unconsciousness, dilated pupils, absence of spontaneous respirations and convulsions. The use of intravenous urea (1 gm./Kg. ) and deliberately induced, controlled hypothermia has been valuable in the prevention of irreversible central nervous system damage. The judicious use of sedative agents such as meperidine, promethazine, phenobarbital, diphenylhydantoin sodium, thiopentone and paraldehyde has been shown to be a valuable adjunct to hypothermia and in control of convulsions.
Résumé
Nous avons choisi six cas parmi un grand nombre de cas cliniques et nous traçons une ligne de conduite à suivre à la suite d’un arrêt cardiaque. Les mortalités sont attribuables en premier lieu à des lésions du système central. Comme manifestations cliniques, ces lésions produisent des séquelles neurologiques, telles que Thyperthermie, l’inconscience prolongée, des pupilles dilatées, l’absence de respiration spontanée et des convulsions. Pour prévenir l’irréversibilité des lésions du système nerveux central nous croyons avantageux d’employer ’de l’urée par voie endoveineuse (1 grm/Kg) et de provoquer une certaine hypothermie. Pour combattre les convulsions et comme adjuvants à l’hypothermie, il nous a semblé indiqué de recourir à l’usage judicieux de sédatifs tels que la mépéridine, la prométhazine, le phénobarbital, le dilantin, le thiopentone et le paraldehyde.
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Dodds, W.A., Jenkins, L.C. & Hersey, L.W. Management after cardiac arrest. Can. Anaes. Soc. J. 8, 561–567 (1961). https://doi.org/10.1007/BF03021389
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DOI: https://doi.org/10.1007/BF03021389