INTRAOPERATIVE CARDIOPULMONARY-RESUSCITATION IN THE PRONE POSITION

Cardiopulmonary resuscitation (CPR) occasionally is necessary in the o perating room setting. In such instances, it may be difficult to perfo rm CPR if the patient is in the prone position. Although the supine po sition is optimal for CPR, it may not be feasible because of the risks of damage to craniospinal structures. The authors present the case of a ll year-old boy who had cardiac arrest during spinal fusion. Succes sful CPR was performed with the patient in the prone position, with th e use of ''reversed precordial compressions,'' and the patient was res uscitated despite 7 minutes of asystole. Effective cardiac output was maintained end was confirmed by systolic blood pressure readings of 80 to 90 mm Hg on both the arterial catheter waveform and the noninvasiv e blood pressure cuff, by a waveform and the reading on the pulse oxim eter, and by the presence of end-tidal carbon dioxide.