Cardiac Arrest in the Surgical Patient

Secondary causes of cardiac arrest in the Surgical Patient

• hypoxia / anoxia – raised potassium, asystole
• hypercapnia – raised catecholamines, raised potassium, reduced pH → reduced contraction and conduction
• anaesthetics – especially high-dose volatile
• vagal reflex mechanisms
  • surgical instrumentation
    • dilation of cervix
    • traction on inferior rectus
    • respiratory tract
• hyperkalaemia
  • sudden increase → VF
  • slow increase → asystole
• circulating catecholamines
• overdose digoxin, quinidine
• severe blood loss – inadequate coronary perfusion
• air embolism
• fainting
• cardiac catheterisation, angiocardiography
• contrast media – anaphylaxis