ON THE RECOVERY OF THE HEART IN ELECTRIC SHOCK

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Abstract
Methods heretofore suggested for the recovery of the heart in electric shock have not been found efficacious. The new method here described calls for the central carotid injection of the remedial solutions, saturated with O and warmed to body temp., at a pressure of 150 mm. Hg. The arterial pressure being practically at 0, the solutions thus injected readily find their way into the coronary arteries. The first solution (KCI 0.5%, NaCl 0.9% plus heparin 0.25 mgm. per cc), about 13 cc. per kgm., establishes K inhibition and the heart is allowed to rest for 1 min. The 2nd solution (CaCl2, 0.023%; NaCl, 0.9%), about 25 cc. per kgm., washes the excess of K out of the coronary bed and substitutes a relative excess of CaCl2, the effect of which is to stimulate a normal cardiac rhythm. This effect is enhanced by the coincident injection of 1 cc. of 1: 1000 adrenalin chloride. In 12 experiments on dogs (of which 3 were killed) the heart was in fibrillation l-184 min.; recovery was complete in 4 dogs, in 2 of which the heart had been in fibrillation for 5 min.

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