Characteristics of mechanical CPR-related injuries: A case series

Hemorrhagic shock due to ruptured idiopathic intramural hematoma of the sigmoid colon—An autopsy case report

“…The most common cause of intramural hematoma of the colon is blunt abdominal trauma, followed by anticoagulant therapy and blood dyscrasia [8] . In this case, the patient had received mechanical chest compressions but sigmoid colon injury was unlikely to have resulted as a complication of these [11] . Gastrointestinal hematomas are estimated to occur in 1 of every 250,000 anticoagulated patients [12] .…”

Subacute Aortic Rupture Due to Mechanical Chest Compression with Indwelling Impella

“… 1 The patient described required 62 minutes of ACCD support and fits into the longer CPR group as defined by Ondruschka et al 1 The data on fatal injuries due to mechanical CPR is inconclusive. While Milling et al reported a 10% incidence of fatal injuries after mechanical CPR with the LUCAS device, 2 Smekal et al did not detect a single fatal injury in 139 patients resuscitated with the LUCAS device. 5 …”

“… 4 Numerous reports have described more injuries with ACCDs than with standard manual CPR. 1 2 5 Ondruschka et al 1 demonstrated more frequent hemothorax (8.9 vs. 1.2%), pneumothorax (6.2 vs. 0.6%), and lung lesions (18.6 vs. 4%) with ACCD versus manual CPR. Great vessel injury was rare (2.7 vs. 1.2%), but no major injury could be identified as the cause of death.…”

“…Milling et al described a 10% incidence of LUCAS-related life-threatening injuries in 50 autopsies. 2 …”

Optimizing hemodynamic function during cardiopulmonary resuscitation

“…Based on one CEA-injected cadaver, sequential chest compressions delivered by a static compression device caused atrial compression and slight right ventricular compression, but no compression of the left ventricle, which instead moved inferiorly and laterally. The methodology enabled observation of, e.g., substantial liver and kidney displacement during simulated dynamic chest compressions [11 ▪ ], outlining the potential for in-depth investigation of thoracic organ movement and deformation during chest compressions and possibly unnoticed components of characteristic resuscitation injuries [12,13 ▪ ,14].…”