More on Open-Chest Cardiac Massage after Cardiac Arrest

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To the Editor: The results of the prospective clinical trial of open-chest cardiopulmonary resuscitation (CPR) reported by Geehr and his associates (May 1 issue)1 are important, but predictable from data on animals.1 2 3 Previously published clinical and animal studies have shown that open-chest CPR provides better hemodynamics than closed-chest compression.2 3 4 5 It remains uncertain, however, whether improvements in hemodynamics result in improved resuscitation and long-term survival. We approached this question in an animal model of cardiac arrest and found that after 15 minutes of closed-chest massage, open-chest CPR improved resuscitation, as compared with continued efforts by closed-chest techniques.2 However, there was no . . .