Atrial Rupture in a Child from Cardiac Massage by His Parent

Reardon, Michael J.; Gross, Donald M.; Vallone, Ambrose M.; Weiland, Anne P.; Walker, William E.

doi:10.1016/s0003-4975(10)60211-1

Cited by 23 publications

(8 citation statements)

References 8 publications

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“…Four LOE 5 276 -279 reports document bystander CPR-related injuries in individual cases. Only 1 of these 276 was a patient who was not in cardiac arrest.…”

Section: Consensus On Sciencementioning

confidence: 99%

Part 5: Adult Basic Life Support

Sayre¹,

Koster²,

Botha³

et al. 2010

Circulation

151

136

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“…Four LOE 5 276 -279 reports document bystander CPR-related injuries in individual cases. Only 1 of these 276 was a patient who was not in cardiac arrest.…”

Section: Consensus On Sciencementioning

confidence: 99%

Part 5: Adult Basic Life Support

Sayre¹,

Koster²,

Botha³

et al. 2010

Circulation

151

136

View full text Add to dashboard Cite

“…12, 13 In a pooled analysis, pericardial injury occurs in 8.9% and hemopericardium occurs in 7.5% of CPR-treated patients (Table 1) following standard or ACD-CPR. 5, 6, 8, 11, 13–22 Resultant cardiac tamponade has been described as well 17, 23–26 either with or without associated pericardial laceration.…”

Section: Resultsmentioning

confidence: 99%

“…A broad spectrum of cardiac injuries have been observed including both contusions of the epi-, myo-, or endocardium (4.4%, 1.7%, and 3% respectively) 5–7, 9–11, 18, 26–31 and lacerations or chamber ruptures (0.6%) involving the right atrium, 13, 15, 23, 24 right ventricle, 13, 28, 32–34 left ventricle, 5, 12, 18, 25, 28 or locations not specified. 5, 14, 17 Cardiac rupture has been associated with thoracic wall injuries or myocardium weakened by ischemia.…”

Section: Resultsmentioning

confidence: 99%

A systematic review and pooled analysis of CPR-associated cardiovascular and thoracic injuries

et al. 2014

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OBJECTIVE The incidence of thoracic injuries resulting from cardiopulmonary resuscitation (CPR) is not well characterized. We describe a case in which a CPR-associated atrial rupture was identified with ultrasound and successfully managed in the intensive care unit with a bedside thoracotomy and atrial repair. We then describe a systematic review with pooled data analysis of CPR-associated cardiovascular, pulmonary, pleural, and thoracic wall injuries. DATA SOURCES PubMed, Scopus, EMBASE, and Web of Science were searched to identify relevant published studies. Unpublished studies were identified by searching the Australian and New Zealand Clinical Trials Registry, World Health Organization International Clinical Trials Registry Platform, Cochrane Library, ClinicalTrials.gov, Current Controlled Trials, and Google. STUDY SELECTION Inclusion criteria for the pooled analysis were any clinical or autopsy study in which a) patients underwent cardiopulmonary resuscitation, b) chest compressions were administered either manually or with the assistance of active compression-decompression devices, and c) autopsy or dedicated imaging assessments were conducted to identify complications. Exclusion criteria for the pooled analysis were pre-clinical studies, case reports and abstracts. DATA EXTRACTION Nine-hundred twenty-eight potentially relevant references were identified. Twenty-seven references met inclusion criteria. DATA SYNTHESIS A systematic review of the literature is provided with pooled data analysis. CONCLUSIONS The incidence of reported CPR-associated cardiovascular and thoracic wall injuries varies widely. CPR with active compression-decompression devices has a higher reported incidence of cardiopulmonary injuries. Bedside ultrasound may be a useful adjunct to assess and risk-stratify patients to identify serious or life-threatening CPR-associated injuries.

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“…[21][22][23][24] These include injuries such as cardiac rupture, 22 hepatic laceration, 23 and gastric perforation. 21 In the absence of a more plausible explanation these injuries are often attributed to the resuscitation efforts.…”

Section: Discussionmentioning

confidence: 99%

Do resuscitation attempts in children who die, cause injury?

Ryan

Young²,

Wells³

2003

Emergency Medicine Journal

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Objective: To determine the incidence, type, and pattern of injury related to resuscitation attempts in children who die. Design: Retrospective review of ambulance, hospital, and necropsy case records. Method: All children who died aged 0-14 years between 1994 and 1996, and underwent a full necropsy at the Victorian Institute of Forensic Medicine (Melbourne, Australia) were identified. Children who were subject to recognised trauma before resuscitation or died because of a congenital abnormality were excluded. The records of all remaining children were reviewed. Children were grouped according to whether resuscitation was attempted or not. Results: From a total of 346 children who died, 204 (58.6%) were identified as meeting the inclusion criteria. Resuscitation was performed in 153 (75%) children and was started before ambulance arrival in 123 (60.3%) children. Injuries were detected at necropsy in 65 (42.5%) of children who had resuscitation compared with six (11.7%) of children who had no resuscitation (p<0.0001) χ 2 test. All but two of these injuries were of a minor nature consisting principally of bruises or abrasions. Two significant injuries were identified both occurring as a result of readily identifiable resuscitation procedures. The likelihood of injury increased with the length of resuscitation. In children resuscitated for less than 60 minutes the incidence of injury was 27% compared with 62% for children resuscitated for longer ( p<0.0001). Conclusion: This study has shown that cardiopulmonary resuscitation commonly causes minor injuries such as superficial bruises and abrasions and the likelihood of such injury increases with the duration of the cardiopulmonary resuscitation. This information should reassure parents and caregivers that basic life support may be instituted without fear of causing significant injury or adversely affecting outcome in the child with cardiorespiratory arrest. Caution must be exercised when attributing significant injuries to resuscitation attempts and alternative causes must be fully investigated. C ardiopulmonary resuscitation (CPR) is a widely promoted practice that is actively taught to the general public as well as medical, nursing, and paramedical personnel. It has been estimated that one in 40 Australians have received formal training in CPR 1 although it is unknown how often it is actually performed.As CPR consists of a series of physical manoeuvres performed by one or more individuals upon another, the potential exists for injuries to occur to the recipient. A wide range of injuries have been described as being inflicted during CPR.2-8 These range from superficial bruising through to chest or airway injury that is likely to impair the resuscitation attempt. The overall incidence of injury has been estimated at between 20%-65% in adults 4 6 7 9 and 7% in children.10

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Atrial Rupture in a Child from Cardiac Massage by His Parent

Cited by 23 publications

References 8 publications

Part 5: Adult Basic Life Support

Part 5: Adult Basic Life Support

A systematic review and pooled analysis of CPR-associated cardiovascular and thoracic injuries

Do resuscitation attempts in children who die, cause injury?

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