The effectiveness of hypertonic glucose in resuscitation of the hypothermic heart following potassium chloride arrest.

ONE method of overcoming ventricular fibrillation is to produce cardiac arrest by perfusion of the coronary circulation with potassium and restoring a normal rhythm by cardiac massage. Resuscitation of the hypothermic heart after potassium arrest frequently requires prolonged massage, but if hypertonic glucose is administered intravenously when the myocardium is in the "responsive phase", spontaneous contraction occurs more quickly and the heart recovers sooner. The effectiveness of potassium in arresting ventricular fibrillation produced by faradic stimulation in normothermic animals has been studied by Wiggers.'' Cardiac arrest in diastole was produced by injecting potassium chloride solution directly into the ventricles. A normal cardiac beat could be frequently obtained by cardiac massage and the injection of calcium chloride. The potassium ion produces a depression of conduction of the myocardial fibers (Fenn). Wiggers concluded that fibrillation resulted with small amounts of potassium when some areas of the myocardium escaped depression, and cardiac arrest occurred when all areas were depressed by larger doses. Swan and his associates'1 8 abrogated fibrillation in the hypothermic heart by perfusing the coronary circulation with potassium