Open indirect cardiac massage in neonate.

Open, direct cardiac massage (OCM), as a technique of resuscitation has not been very inspiring due to its various limitations. We report a case of resuscitation where open 'indirect' cardiac massage was used to resuscitate a neonate successfully. A 24 hr old neonate with multiple gastrointestinal anomalies presented for emergency laparotomy. Intraoperatively she suffered a cardiac arrest. External chest compressions (ECC) failed to produce detectable circulation and surgeons were asked to initiate direct cardiac compressions. They could palpate and successfully compress the heart without the need to split the diaphragm. This 'infra-diaphragmatic' approach resulted in adequate circulation and subsequent uncomplicated recovery.