Fatal Pancreatic Injury due to Trauma after Successful Cardiopulmonary Resuscitation with Automatic Mechanical Chest Compression

Deras, Pauline; Manzanera, Jonathan; Millet, Ingrid; Charbit, Jonathan; Capdevila, Xavier

doi:10.1097/aln.0000000000000147

Cited by 18 publications

(7 citation statements)

References 20 publications

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“…Granted, some of these adverse effects can be mitigated with proper training. However, there are case reports of patients succumbing to solid organ injury after a successful resuscitation with mechanical CPR ( 19 ). Additionally, mechanical CPR devices vary in their structure and design and certain devices use a suction cup to ensure that complete chest recoil is obtained.…”

Section: Discussionmentioning

confidence: 99%

The Use of Mechanical Cardiopulmonary Resuscitation May Be Associated With Improved Outcomes Over Manual Cardiopulmonary Resuscitation During Inhospital Cardiac Arrests

Crowley

Wan²,

Salciccioli

et al. 2020

Critical Care Explorations

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Objectives: We aimed to investigate the impact of mechanical cardiopulmonary resuscitation devices over manual cardiopulmonary resuscitation on outcomes from inhospital cardiac arrests. Design: Restrospective review. Setting: Single academic medical center. Participants: Data were collected on all patients who suffered cardiac arrest from December 2015 to November 2019. Main Outcomes and Measures: Primary end point was return of spontaneous circulation. Secondary end points included survival to discharge and survival to discharge with favorable neurologic outcomes. Results: About 104 patients were included in the study: 59 patients received mechanical cardiopulmonary resuscitation and 45 patients received manual cardiopulmonary resuscitation during the enrollment period. Return of spontaneous circulation rate was 83% in the mechanical cardiopulmonary resuscitation group versus 48.8% in the manual group (p = 0.009). Survival-to-discharge rate was 32.2% in the mechanical cardiopulmonary resuscitation group versus 11.1% in those who received manual cardiopulmonary resuscitation (p = 0.02). Of the patients who survived to discharge and received mechanical cardiopulmonary resuscitation, 100% (n = 19) had a favorable neurologic outcome versus 40% (two out of five) of patients who survived and received manual cardiopulmonary resuscitation (p = 0.005). Conclusions: Our findings demonstrate a significant association of improved outcomes with mechanical cardiopulmonary resuscitation over manual cardiopulmonary resuscitation during inhospital cardiac arrests. Mechanical cardiopulmonary resuscitation may improve rates of return of spontaneous circulation, survival to discharge, and favorable neurologic outcomes.

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Section: Discussionmentioning

confidence: 99%

The Use of Mechanical Cardiopulmonary Resuscitation May Be Associated With Improved Outcomes Over Manual Cardiopulmonary Resuscitation During Inhospital Cardiac Arrests

Crowley

Wan²,

Salciccioli

et al. 2020

Critical Care Explorations

View full text Add to dashboard Cite

show abstract

“…Iatrogenic abdominal parenchymatic injuries could be associated with deeper chest compressions. There are reports also in cases of automatic mechanical chest compression that support this hypothesis [ 12 , 13 ]. Kralj et al reported 0.85% (3/353) CPR-related iatrogenic injury rate in the period 2004–2005, increase of these injury rate to 1.31% (14/1072) in the period 2006–2010, and further increase to 1.85% (14/723) in the period 2011–2013 [ 2 ].…”

Section: Discussionmentioning

confidence: 94%

Intra-Abdominal Hemorrhage following Cardiopulmonary Resuscitation: A Report of Two Cases

Koutserimpas

Ioannidis

Siaperas

et al. 2018

Case Reports in Emergency Medicine

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Cardiopulmonary resuscitation (CPR) represents an emergency procedure, consisting of chest compressions and artificial ventilation. Two rare cases of intra-abdominal bleeding following cardiac compressions are reported. The first case was a 29-year-old female with massive pulmonary embolism (PE). Following CPR due to cardiac arrest, she showed signs of intra-abdominal bleeding. A liver laceration was found and sutured. The patient passed away, due to massive PE. The second patient was a 62-year-old female, suffering from cardiac arrest due to drowning at sea. CPR was performed in situ. At presentation to the emergency department she showed signs of intra-abdominal bleeding. The origin of the hemorrhage was found to be vessels of the lesser curvature of the stomach, which were ligated. Regarding the first patient PE has already been described as a cause for liver lacerations in CPR due to stasis and liver enlargement. The second case is the first report of gastric vessel injury without gastric rupture/laceration and pneumoperitoneum. Complications of CPR should not represent a drawback to performing cardiac compressions. Parenchymatic injuries have been related to inappropriate technique of chest compressions during basic life support. Therefore, it is of utmost importance for the providers to refresh their knowledge of performing CPR.

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“…LUCAS™, Physio-Control; Lund, Sweden) have been developed to substitute high-tech performance for human efforts and support transportation. Although these devices provide a continuously improving quality of manual chest compressions, possible risks of injuring lung, heart, liver, spleen and chest wall have to be considered [18, 19]. Even though the patient was transported using a compression device, the severe metabolic acidosis with high lactate levels and low pH at the time of arrival were indicative of severe ischemia followed by a continued, generalized low-flow/low-pressure situation..…”

Section: Discussionmentioning

confidence: 99%

Controlled automated reperfusion of the whole body after 120 minutes of Cardiopulmonary resuscitation: first clinical report

Trummer¹,

Supady

Beyersdorf

et al. 2017

Scand J Trauma Resusc Emerg Med

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BackgroundCardiopulmonary resuscitation (CPR) is associated with a high mortality rate. Furthermore, the few survivors often have severe, persistent cerebral dysfunction. A potential cause for this unsatisfactory outcome after CPR is the combination of cardiac arrest (ischemia) and the inability to restore adequate hemodynamics during conventional CPR (reperfusion), resulting in ischemia/reperfusion injury of the whole body. Therefore we developed a concept counteracting this ischemia/reperfusion injury during the process of CPR.Case presentationWe present data from a patient, in whom the concept of a novel controlled automated reperfusion of the whole body (CARL) was applied after 120 min of CPR under normothermic conditions. The patient survived without cerebral deficits and showed full recovery of all organs after prolonged cardiac arrest (CA) except for the spinal cord, where a defect at the level of the 11th thoracic vertebra caused partial loss of motoric function of the legs.ConclusionThis is the first reported clinical application of CARL after CA. The implementation of CARL resulted in unexpected survival and recovery after prolonged normothermic CA and CPR. In synopsis with the preclinical experience in pigs this case shows, that the new concept of CARL treating ischemia/reperfusion during the CPR may be an important element within the future treatment of CA.Trial RegistrationTrial was retrospectively registered in the “German Clinical Trials Register” (www.germanctr.de) under No.: DRKS00005773 on July 28th, 2015.

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Fatal Pancreatic Injury due to Trauma after Successful Cardiopulmonary Resuscitation with Automatic Mechanical Chest Compression

Cited by 18 publications

References 20 publications

The Use of Mechanical Cardiopulmonary Resuscitation May Be Associated With Improved Outcomes Over Manual Cardiopulmonary Resuscitation During Inhospital Cardiac Arrests

The Use of Mechanical Cardiopulmonary Resuscitation May Be Associated With Improved Outcomes Over Manual Cardiopulmonary Resuscitation During Inhospital Cardiac Arrests

Intra-Abdominal Hemorrhage following Cardiopulmonary Resuscitation: A Report of Two Cases

Controlled automated reperfusion of the whole body after 120 minutes of Cardiopulmonary resuscitation: first clinical report

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