More on Open-Chest Cardiac Massage after Cardiac Arrest

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.