Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Aug 18:5:64.
doi: 10.1186/1749-8090-5-64.

Are chest compressions safe for the patient reconstructed with sternal plates? Evaluating the safety of cardiopulmonary resuscitation using a human cadaveric model

Douglas R McKay  1 , Hosam F Fawzy, Kathryn M McKay, Romy Nitsch, James L Mahoney
Affiliations

Are chest compressions safe for the patient reconstructed with sternal plates? Evaluating the safety of cardiopulmonary resuscitation using a human cadaveric model

Douglas R McKay et al. J Cardiothorac Surg. .

Abstract

Background: Plate and screw fixation is a recent addition to the sternal wound treatment armamentarium. Patients undergoing cardiac and major vascular surgery have a higher risk of postoperative arrest than other elective patients. Those who undergo sternotomy for either cardiac or major vascular procedures are at a higher risk of postoperative arrest. Sternal plate design allows quick access to the mediastinum facilitating open cardiac massage, but chest compressions are the mainstay of re-establishing cardiac output in the event of arrest. The response of sternal plates and the chest wall to compressions when plated has not been studied. The safety of performing this maneuver is unknown. This study intends to demonstrate compressions are safe after sternal plating.

Methods: We investigated the effect of chest compressions on the plated sternum using a human cadaveric model. Cadavers were plated, an arrest was simulated, and an experienced physician performed a simulated resuscitation. Intrathoracic pressure was monitored throughout to ensure the plates encountered an appropriate degree of force. The hardware and viscera were evaluated for failure and trauma respectively.

Results: No hardware failure or obvious visceral trauma was observed. Rib fractures beyond the boundaries of the plates were noted but the incidence was comparable to control and to the fracture incidence after resuscitation previously cited in the literature.

Conclusions: From this work we believe chest compressions are safe for the patient with sternal plates when proper plating technique is used. We advocate the use of this life-saving maneuver as part of an ACLS resuscitation in the event of an arrest for rapidly re-establishing circulation.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Plated sternum.
Figure 2
Figure 2
Rib fractures after resuscitation.
Figure 3
Figure 3
Elevation and examination of deep sternal cortex and viscera.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Wik L. et al.Delaying defibrillation to give basic cardiopulmonary resuscitation by patients with out of hospital ventricular fibrillation: a randomized trial. JAMA. 2003;289:1389–95. doi: 10.1001/jama.289.11.1389. - DOI - PubMed
    1. Kern KB. Cardiopulmonary resuscitation without ventilation. Crit Care Med. 2000. p. N186-9. - PubMed
    1. Yuen JC, Zhou AT, Serafin D, Gerogiade DS. Long-term sequelae following median sternotomy wound infection and flap reconstruction. Ann Plast Surg. 1995;35:585–589. doi: 10.1097/00000637-199512000-00005. - DOI - PubMed
    1. Cicilioni OJ, Stieg FH, Papanicolaou G. Sternal wound reconstruction with transverse plate fixation. Plast Reconstr Surg. 2005;115(5):1297–30. doi: 10.1097/01.PRS.0000156918.15595.85. - DOI - PubMed
    1. Detsky AS, Abrams HB, McLaughlin JR. et al.Predicting cardiac complications in patients undergoing non-cardiac surgery. J Gen Intern Med. 1986;1(4):211–9. doi: 10.1007/BF02596184. - DOI - PubMed

Publication types