Complications of mechanical chest compression devices

Platenkamp, M.; Otterspoor, Luuk C.

doi:10.1007/s12471-013-0491-y

Cited by 18 publications

(14 citation statements)

References 20 publications

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“…The goal of a rapid return of a spontaneous circulation is to maintain cerebral and coronary oxygenation through blood flow, while awaiting definitive coronary therapy. While advances have been made in the provision of mechanical chest compressions to allow for simultaneous PCI, complications include skeletal injury, skin injury, vascular injury, and ruptured or bleeding viscera . Likewise, the force necessary to provide effective mechanical compression may generate motion that interferes with the angiographic procedure.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of extracorporeal membrane oxygenation support in the cardiac catheterization laboratory

Parr

Sharma

Arora

et al. 2019

Cathet Cardio Intervent

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Objectives The aims of this single‐center retrospective study were to characterize and determine predictors of 30‐day survival in a cohort of patients requiring venoarterial extracorporeal membrane oxygenation (VA‐ECMO) supported cardiopulmonary resuscitation (E‐CPR) in the cardiac catheterization laboratory (CCL) for cardiac arrest (CA) or refractory cardiogenic shock (CS). Background While safety in the CCL has improved, periprocedural mortality from CA remains high. The application of VA‐ECMO is an emerging form of resuscitation with a paucity of data evaluating its use in the CCL for CA or CS. Methods All consecutive patients aged 18 years or older presenting to a single CCL from October 2010 to May 2018 who required E‐CPR for CA or refractory CS were included. The primary outcome of our study was overall survival 30 days from VA‐ECMO initiation. Secondary outcomes included 1‐year survival, hospital length of stay, and ECMO related complications. Results Sixty‐two patients with a mean age of 60 ± 9 years, 63% male, were included. VA‐ECMO was initiated for CA in 39 patients (63%) and for CS in 23 patients (37%). The median ECMO duration was 48 hr. Overall 30‐day survival was 47% (CA group 44% vs. CS group 52%; p = .414). One‐year survival was 44%. Initial serum creatinine (OR 1.18 per 10 μmol/L increase; p = .016; AUC = 0.65) was the only multivariate predictor of 30‐day mortality. Conclusions The use of VA‐ECMO in the CCL is feasible, demonstrating 47% 30‐day survival, largely persistent to 1 year, in a cohort that otherwise has extremely high mortality.

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Section: Introductionmentioning

confidence: 99%

Outcomes of extracorporeal membrane oxygenation support in the cardiac catheterization laboratory

Parr

Sharma

Arora

et al. 2019

Cathet Cardio Intervent

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“…When comparing the CT scans of this patient from before and 12 hours after ECPR, the aortic dissection was a new finding that was likely related to manual CPR or mechanical CPR using the LUCAS. The RP hemorrhage may also be related to the LUCAS, since liver, spleen, and gastric injuries have been reported 4 . However, it should be kept in mind that also the ECMO cannulation could have caused the RP hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, this technology is not without risk. The LUCAS‐related complications have been described from minor (skin lesions) to major (sternal fracture, rib fractures) and include life‐threatening complications (cardiopulmonary injury or aortic dissection) 4 …”

Section: Discussionmentioning

confidence: 99%

Mechanical cardiopulmonary resuscitation for venoarterial ECMO implantation in pulmonary embolism complicated by type B aortic dissection and retroperitoneal hemorrhage

Maybauer

Banayosy²,

Koerner

et al. 2020

J Card Surg

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A patient with acute pulmonary embolism suffered cardiac arrest, received manual and mechanical cardiopulmonary resuscitation and tissue plasminogen activator before extracorporeal cardiopulmonary resuscitation was initiated. She suffered a type B aortic dissection and retroperitoneal hemorrhage secondary to resuscitation measures. This case report describes high-risk anticoagulation management for contradicting treatment goals in preparation for pulmonary embolectomy on cardiopulmonary bypass.

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“…The three errors were ‘ failure to place the shoulder strap ’, ‘ failure to press button 2 ’ and ‘ incorrect orientation of the M-CPR device ’. A failure to place the shoulder strap is important because it can lead to device migration causing iatrogenic injury 23. This error was identified as a latent safety threat and has led to further training provided at regular intervals.…”

Section: Discussionmentioning

confidence: 99%

Randomised controlled trial of simulation-based education for mechanical cardiopulmonary resuscitation training

Coggins¹,

Nottingham

et al. 2019

Emerg Med J

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IntroductionMechanical cardiopulmonary resuscitation (M-CPR) is increasingly used in the management of cardiac arrest. There are no previously reported randomised studies investigating M-CPR training. This study of newly trained M-CPR providers hypothesised that a brief simulation-based intervention after 4 months would improve M-CPR performance at 6 months.MethodsThis study used a simulated ‘in situ’ cardiac arrest model. The M-CPR device used was a proprietary Lund University Cardiac Assist System 3 machine (Physio Control, Redmond, Washington, USA). Standardised baseline training was provided to all participants. Following training, baseline performance was assessed. The primary outcome measure was the time taken to initiate M-CPR and the secondary outcome was performance against a checklist of errors. Participants were then randomised to intervention group (simulation training) or control group (routine clinical use of M-CPR). After 6 months the outcome measures were reassessed. Comparative statistical tests used an intention-to-treat analysis.Results112 participants were enrolled. The intervention group (n=60) and control group (n=52) had similar demographic characteristics. At the 6-month assessment, median time to M-CPR initiation was 27.0 s (IQR 22.0–31.0) in the intervention group and 31.0 s (IQR 25.6–46.0) in the control group (p=0.003). The intervention group demonstrated fewer errors compared with controls at 6 months (p<0.001)ConclusionIn this randomised study of approaches to M-CPR training, providers receiving additional simulation-based training had higher retention levels of M-CPR skills. Therefore, when resuscitation skills are newly learnt, provision follow-up training should be an important consideration.

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Complications of mechanical chest compression devices

Cited by 18 publications

References 20 publications

Outcomes of extracorporeal membrane oxygenation support in the cardiac catheterization laboratory

Outcomes of extracorporeal membrane oxygenation support in the cardiac catheterization laboratory

Mechanical cardiopulmonary resuscitation for venoarterial ECMO implantation in pulmonary embolism complicated by type B aortic dissection and retroperitoneal hemorrhage

Randomised controlled trial of simulation-based education for mechanical cardiopulmonary resuscitation training

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