Skeletal and soft tissue injuries after manual and mechanical chest compressions

Friberg, Niklas; Walther, Charles S; Englund, Elisabet

doi:10.1093/ehjqcco/qcy062

Cited by 23 publications

(12 citation statements)

References 35 publications

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“…The only randomised trial of devicerelated injuries so far did not include the Corpuls CPRdevice used in this study, but the piston-based device analysed in that study, LUCAS, was found to be noninferior to manual CPR in terms of severe injuries [17]. By contrast, in two other recently published large studies, patients resuscitated with the LUCAS-device had more resuscitation-related injuries [18,19], even though this effect lost statistical significance after adjusting for CPRduration in one of the studies [18]. In case of evacuation from an upper floor, we would still suggest using CPRdevices, even if their injury potential were higher, because of the improvement of CPR-quality versus manual CPR, which performs poorly in this situation.…”

Section: Discussionmentioning

confidence: 85%

Rescue under ongoing CPR from an upper floor: evaluation of three different evacuation routes and mechanical and manual chest compressions: a manikin trial

Drinhaus

Nüsgen²,

Adams

et al. 2020

Scand J Trauma Resusc Emerg Med

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Background: If transport under ongoing cardiopulmonary resuscitation (CPR) from an upper floor is indicated, the ideal CPR-method and evacuation route is unknown hitherto. We aimed to elaborate a strategy for evacuation of patients under ongoing CPR from an upper floor, comparing three different evacuation routes and manual and mechanical chest compressions. Methods: A CPR-training manikin recording CPR-quality was placed on the fifth floor and was evacuated to an ambulance via lift, turntable ladder, or staircase. Chest compressions were performed manually or with a mechanical CPR-device. Efficiency endpoints were compression depth and frequency, sufficiency of chest release, compared with European Resuscitation Council (ERC) Guidelines, and duration of the evacuation. Adverse outcomes were disconnection/dislocation of devices and hazards/accidents to the personnel.Results: For all evacuation routes, compression depth and frequency were significantly more compliant with ERCguidelines under mechanical CPR. Manual CPR was associated with considerable deviations from correct compression depth and frequency. Chest release only slightly differed between groups. Evacuation via lift under mechanical CPR was fastest and evacuation via turntable ladder under manual CPR was slowest. No device disconnections or accidents occurred, but hazard to personnel was perceived during evacuation via ladder under manual CPR. Conclusions:In this study, a mechanical CPR-device proved to deliver better CPR-quality during evacuation from an upper floor. If a lift accessible with a stretcher is available, this route should be preferred, regardless of manual or mechanical CPR. Turntable ladders can only be meaningfully used with mechanical CPR, otherwise CPR-quality is poor and hazard to the personnel is increased. Not all evacuation routes may be useable in a specific real-life scenario.

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Section: Discussionmentioning

confidence: 85%

Rescue under ongoing CPR from an upper floor: evaluation of three different evacuation routes and mechanical and manual chest compressions: a manikin trial

Drinhaus

Nüsgen²,

Adams

et al. 2020

Scand J Trauma Resusc Emerg Med

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show abstract

“…There are also concerns regarding potential injuries from the more powerful compressions delivered. Observational studies found that LUCAS CPR resulted in a higher incidence of skeletal and soft tissue injury than manual CPR ( 9 , 10 ). Conversely, a recent randomized controlled trial did not find that the LUCAS caused any more serious or life-threatening visceral damage than manual CPR did ( 11 ).…”

Section: Discussionmentioning

confidence: 99%

A Case of an Aortic Dissection After Mechanical Chest Compression by LUCAS

Kopriva

Dehghani³

2020

JACC: Case Reports

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A 68-year-old man presented following a cardiac arrest. Cardiopulmonary resuscitation was performed by the Lund University Cardiopulmonary Assist System (LUCAS), a mechanical chest compression device. Investigations revealed an aortic dissection, which was likely an iatrogenic injury from mechanical cardiopulmonary resuscitation by LUCAS. This case highlights this potential complication. ( Level of Difficulty: Beginner. )

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“…In an animal model, the LUCAS™ device shows superior resuscitation outcomes and less thoracic injuries, compared to the Corpuls CPR [ 63 ]. However, in forensic autopsy studies, the use of LUCAS™ compared with manual CPR was associated in part with significantly higher rates of sternal fractures, rib fractures, and severe soft tissue injuries, including several case reports of potentially life-threatening injuries [ 64 , 65 , 66 , 67 ]. In comparison, the patterns of trauma in autopsy records between AutoPulse ® CPR and manual CPR showed different characteristic patterns of injuries.…”

Section: Introductionmentioning

confidence: 99%

Manual and Mechanical Induced Peri-Resuscitation Injuries—Post-Mortem and Clinical Findings

Gödde¹,

Bruckschen

Burisch³

et al. 2022

IJERPH

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(1) Background: Injuries related to resuscitation are not usually systematically recorded and documented. By evaluating this data, conclusions could be drawn about the quality of the resuscitation, with the aim of improving patient care and safety. (2) Methods: We are planning to conduct a multicentric, retrospective 3-phased study consisting of (1) a worldwide literature review (scoping review), (2) an analysis of anatomical pathological findings from local institutions in North Rhine-Westphalia, Germany to assess the transferability of the review data to the German healthcare system, and (3) depending on the results, possibly establishing potential prospective indicators for resuscitation-related injuries as part of quality assurance measures. (3) Conclusions: From the comparison of literature and local data, the picture of resuscitation-related injuries will be focused on and quality indicators will be derived.

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Skeletal and soft tissue injuries after manual and mechanical chest compressions

Cited by 23 publications

References 35 publications

Rescue under ongoing CPR from an upper floor: evaluation of three different evacuation routes and mechanical and manual chest compressions: a manikin trial

Rescue under ongoing CPR from an upper floor: evaluation of three different evacuation routes and mechanical and manual chest compressions: a manikin trial

A Case of an Aortic Dissection After Mechanical Chest Compression by LUCAS

Manual and Mechanical Induced Peri-Resuscitation Injuries—Post-Mortem and Clinical Findings

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