Pneumothoraces Post Mechanical Cardiopulmonary Resuscitation: A Case Series

Abstract

The incidence of pneumothoraces with automated cardiopulmonary resuscitation (CPR) is unknown. Herein, we present 4 cases of pneumothoraces occurring in the setting of automated mechanical CPR (AM-CPR) in a 2-month period since incorporating mechanical devices into our resuscitation program. Two of the cases were in-hospital cardiac arrests, whereas the other 2 were out-of-hospital cardiac arrests. The Life-Stat 1008 device was utilized for AM-CPR in all cases. All cases demonstrated confirmed pneumothoraces on post-resuscitation imaging. Several factors may have contributed to the observed pneumothoraces. Two of the cases presented with obstructive lung disease, whereas the other 2 had underlying malignancy. Suboptimal positioning and failure to secure the included shoulder straps could have led to migration of the piston over the ribs. Further study is needed to determine the incidence of complications for all FDA-approved AM-CPR devices compared with manual chest compressions.

Retrospective Comparison of Prehospital Sustained Return of Spontaneous Circulation (ROSC) Rates Within a Single Basic Life Support Jurisdiction Using Manual vs Lund University Cardiac Assist System (LUCAS-2) Mechanical Cardiopulmonary Resuscitation

“…Mechanical chest compressions are not always without harm. Adverse effects of mechanical chest compressions, including pulmonary contusions, lacerations, rib fractures, and pneumothoraces, have been reported and may be a contributing factor as to why we have not witnessed the expected improved survival rates of a mechanical device would predictively provide [3,9].…”

“…It has been proposed that the use of an automated compression device may improve overall cardiopulmonary resuscitation (CPR) quality because of the ability to achieve consistent compression rate and depth, increase chest compression fraction, minimize rescuer fatigue, and allow for rescuers to complete other tasks [3,4]. The Lund University Cardiac Assist System 2 (LUCAS-2) is one such example, being an automated battery-powered piston-driven mechanical chest compression device (mCPR) with a suction cup at the distal end of the piston.…”