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June 19, 1967

Elective Cardiac Arrest for the Management of Massively Bleeding Heart Wounds

Author Affiliations

From the departments of surgery, Los Angeles Orthopedic Hospital and Loma Linda University School of Medicine, Los Angeles.

JAMA. 1967;200(12):1023-1025. doi:10.1001/jama.1967.03120250057008

Insertion of the thumb into a large heart wound will control massive cardiac bleeding, permitting restoration of blood volume with multiple transfusion. The tense aorta indicates satisfactory blood replacement. After inflation of the lungs, cardiac arrest will be tolerated for three to four minutes, providing the blood volume is adequate. The arrest permits removal of the thumb without further bleeding and accurate definitive cardiac suture. Compression of the great vessels anterior to the transverse sinus effectively produces anoxic arrest. Effective arrest may be lifesaving if massive bleeding occurs during closed-heart or other intrathoracic procedures. It must be boldly employed prior to irreparable blood loss.