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Background and Objective: Open-chest cardiopulmonary resuscitation (OCCCPR) may be the only method of increasing the survival rate as well as the cardiorespiratory circulation of blunt chest or abdominal trauma patients undergoing cardiac arrest, however, it has always been a difficult challenge for medical staff to carry out on-sight OCCPR because it requires high level of expertise. Unfortunately, professionally qualified individuals are scarce and rarely participate in Outof-Hospital resuscitations. The aim of this study was to determine the effectiveness of establishing on-sight or early OCCPR and the probability of increasing the success rate of resuscitation in blunt chest or abdominal trauma patients undergoing cardiac arrest. Methods: In a retrospective study, a total of 40 chest/abdominal trauma cardiac arrest cases were collected from 2006 ~ 2015. Patients with blunt trauma and underwent cardiac arrest until the arrival of EMT performing uninterrupted open-chest CPR (OCCPR) of less than 10 minutes or closed-chest CPR of less than 15 minutes were included in this study. The main cause of death was chest/abdominal trauma and on-sight OCCPR were performed by trauma surgeons. According to the recovery, the patients were assigned to three groups: Group 0 Mortality, Group 1 Re-established Circulation and Group 2 Recovery. Results: Of the 40 cases, 6 patients (15.00%) had re-established circulation and was discharged after rehab, 15 patients (37.50%) had re-established circulation but died of other complications, 19 patients (47.50%) was not resuscitated. The average age of the surviving patients was 32.67 ± 17.24 years old, the average age for patients who had re-established circulation was 44.40 ± 15.75 years old. In the mortality group, the average age is 35.32 ± 14.89 years old. When compared, the difference in age among the three groups of patients shows no statistical significance (P = 0.164); the New Injury Severity Score (NISS) of group 0 is 56.00 ± 5.62, and group 1 is 56.00 ± 3.35 and group 2 is 64.21 ± 1.80, the three groups showed no statistical significance in the severity of trauma (P = 0. 072). The amount of time taken from distress call to performing OCCPR in group 2 was 14.50 ± 9.83 minutes, group 1 was 19.73 ± 6.02 minutes, group 0 was 26.58 ± 12.18 minutes, which among the three groups showed statistical significance (P = 0. 025), further comparison also indicates that the difference in time between group 2 and group 0 had statistical significance (P = 0.014). Conclusion: On-sight or early performance of OCCPR is viable and is encouraged to be utilized more in trauma centers. It is proven that early performance of OCCPR can increase the survival rate of those patients with chest and/or abdominal trauma undergoing cardiac arrest. Correspondence to: Wen-Hai Liu, Department of Emergency, Aerospace Center Hospital (Peking University Aerospace School of Clinical Medicine), 100049 Beijing, China, Tel: +86-10-59971204; E-mail: wh717@sina.com

clinical research and trials

Out-of-hospital open-chest cardiopulmonary resuscitation after cardiac arrest in cases of blunt chest or abdominal trauma: A consecutive series of 40 cases