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Adrenaline for stab heart

Jose Luis Danguilan jdanguilan at gmail.com
Tue Dec 15 20:03:54 GMT 2009

On another note, the use of IV adenosine** to facilitate cardiorrhaphy in
penetrating cardiac trauma by inducing temporary asystole is effecttive and
safer than the traditional methods.
Ann Thorac Surg* 2001;71:1714-1715


Jose Luis J. Danguilan, MD

On Tue, Dec 15, 2009 at 8:26 PM, Miranda Voss <mvossak at yahoo.co.uk> wrote:

> I realise it is useless, but I would like to know whether it actually
> causes harm. I wouldn't give it myself, but there are casualty officers who
> see the patient before I do and anesthetists who look after them intra-op. I
> am wondering if we should stop them giving epi/ardenaline.
> Thanks,
> Miranda.
> Simply put, epi is going to be absolutely useless if the heart is
> empty..........You must fuel the engine before turning the key.
> Ron
> -----Original Message-----
> From: trauma-list-bounces at trauma.org [mailto:
> trauma-list-bounces at trauma.org] On Behalf Of Miranda Voss
> Sent: Monday, December 14, 2009 10:20 AM
> To: trauma-list at trauma.org
> Subject: Adrenaline for stab heart
> Interested to read this. Have I understood correctly that adrenaline should
> not be given in penetrating cardiac trauma because the sutures tear out? Had
> exactly that scenario a few weeks ago and it sounds as though this is the
> explanation.
> Apologies if this is common knowledge that I have missed, but pls could I
> get some clarity on the use of adrenaline in cardiopulmonary arrest after
> penetrating trauma in the "cardiac box"? I realise that it doesn't make
> sense physiologically, but is adrenaline contraindicated? Intra-operative
> adrenaline infusions are a common anaesthesiology reaction to patients with
> a poor output and I had never felt the need to discourage them.
> Thanks,
> Miranda
> Worcester, W Cape. SA.
> The problem with any traumatic cardiac arrest is that you need to consider
> the cause. Cardiac laceration is up there in the differential. Suture the
> laceration and if you've got inotropes in the system it will pull itself
> apart.
> Matt Dunn
> EP
> Warwick
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