Comparison of different resuscitation methods with regard to injury patterns in cardiac arrest survivors based on computer tomography

Viniol, Simon; Thomas, Rohit Philip; Gombert, S.; König, Alexander; Betz, Susanne; Mahnken, Andreas H.

doi:10.1016/j.ejrad.2020.109244

Cited by 6 publications

(7 citation statements)

References 25 publications

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“…There were too few patients that received mechanical compressions alone to compare injuries to patients receiving only manual CPR. However, previous studies have shown an increased risk of CWIs in patients with mechanical CPR 4,9,27,28 …”

Section: Discussionmentioning

confidence: 97%

“…However, previous studies have shown an increased risk of CWIs in patients with mechanical CPR. 4,9,27,28 Most patients were excluded on account of not having undergone CT. The indication for CT in patients with successful CPR for OHCA is often to diagnose an underlying cause to the CA, most often pulmonary embolism or aortic dissection or aneurysm.…”

Section: Discussionmentioning

confidence: 99%

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Injury pattern and clinical outcome in patients with and without chest wall injury after cardiopulmonary resuscitation

Hadesi,

Rossi Norrlund,

Caragounis

2023

J Trauma Acute Care Surg

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BACKGROUND Cardiopulmonary resuscitation (CPR), although lifesaving may cause chest wall injury (CWI) because of the physical force exerted on the thorax. The impact of CWI on clinical outcome in this patient group is unclear. The primary aim of this study was to investigate the incidence of CPR-related CWI and the secondary aim to study injury pattern, length of stay (LOS), and mortality in patients with and without CWI. METHODS This is a retrospective study of adult patients who were admitted to our hospital due to cardiac arrest (CA) during 2012 to 2020. Patients were identified in the Swedish CPR Registry and those undergoing CT of the thorax within 2 weeks after CPR were included. Patients with traumatic CA, chest wall surgery prior or after CA were excluded. Demographic data, type and length of CPR, type of CWI, LOS on mechanical ventilator (MV), in intensive care unit (ICU) and in hospital (H), and mortality were studied. RESULTS Of 1,715 CA patients, 245 met the criteria for inclusion. The majority (79%) of the patients suffered from CWI. Chondral injuries and rib fractures were more common than sternum fractures (95% vs. 57%), and 14% had a radiological flail segment. Patients with CWI were older (66.5 ± 15.4 vs. 52.5 ± 15.2, p < 0.001). No difference was seen in MV-LOS (3 [0–43] vs. 3 [0–22]; p = 0.430), ICU-LOS (3 [0–48] vs. 3 [0–24]; p = 0.427), and H-LOS (5.5 [0–85] vs. 9.0 [1–53]; p = 0.306) in patients with or without CWI. Overall mortality within 30 days was higher with CWI (68% vs. 47%, p = 0.007). CONCLUSION Chest wall injuries are common after CPR and 14% of patients had a flail segment on CT. Elderly patients have an increased risk of CWI, and a higher overall mortality is seen in patients with CWI. LEVEL OF EVIDENCE Prognostic and Epidemiological; Level IV.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Injury pattern and clinical outcome in patients with and without chest wall injury after cardiopulmonary resuscitation

Hadesi,

Rossi Norrlund,

Caragounis

2023

J Trauma Acute Care Surg

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“…An autopsy study of cardiac arrest patients found liver rupture in only 2.1% [4] . Even when they occur, it is more often from mechanical rather than manual CPR [5] . Injury to the liver is typically seen within the left lobe, due to its location, and proximity to the anatomic midline—both of which contribute to its susceptibility of injury from compressions [3] .…”

Section: Discussionmentioning

confidence: 99%

Hemoperitoneum identified by focused assessment with sonography for trauma following cardiopulmonary resuscitation

Liu

Roth

Nesbit

et al. 2021

Radiology Case Reports

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It is generally recognized that lives are saved by administering high-quality cardiopulmonary resuscitation (CPR) to patients in cardiac arrest. A focused assessment with sonography for trauma (FAST) examination is an effective and non–invasive method for detecting rare complications of CPR, such as hemorrhage from abdominal visceral injury. We report the case of a 56-year-old female suffering from intra-abdominal hemorrhage caused by a liver laceration following CPR. The hemoperitoneum was diagnosed by a FAST examination. Although severe complications of CPR are rare, they can be easily detected with the use of a FAST examination. A FAST examination should be considered as a post-resuscitation approach to assess for life-threatening complications in all patients following cardiopulmonary resuscitation.

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“…Rib and sternal fractures are the most common complication after CPR, 6 , 7 , 8 with an incidence ranging between 10–96%, irrespective of whether patients survive. 8 , 9 , 10 , 11 The risk of rib fractures further increases with mechanical CPR. 9 , 11 , 12 .…”

Section: Introductionmentioning

confidence: 99%

Left rib fractures during cardiopulmonary resuscitation are associated with hemodynamic variations in a pig model of cardiac arrest

et al. 2023

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Comparison of different resuscitation methods with regard to injury patterns in cardiac arrest survivors based on computer tomography

Cited by 6 publications

References 25 publications

Injury pattern and clinical outcome in patients with and without chest wall injury after cardiopulmonary resuscitation

Injury pattern and clinical outcome in patients with and without chest wall injury after cardiopulmonary resuscitation

Hemoperitoneum identified by focused assessment with sonography for trauma following cardiopulmonary resuscitation

Left rib fractures during cardiopulmonary resuscitation are associated with hemodynamic variations in a pig model of cardiac arrest

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