Fatal complication secondary to mechanical chest compression device

Rooij, Philippe P. de; Wiendels, Dolf R; Snellen, Jacob P.

doi:10.1016/j.resuscitation.2009.06.011

Cited by 20 publications

(7 citation statements)

References 4 publications

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“…A growing number of case reports of skeletal, soft tissue and organ damage have been appearing in the literature in association with mechanical chest compression devices [34][35][36]. This is perhaps not surprising as the injuries that can be sustained during CPR can be dramatic.…”

Section: Injuries Associated With Mechanical Compression Devicesmentioning

confidence: 99%

Mechanical chest-compression devices: current and future roles

Perkins

Brace

Gates

2010

Current Opinion in Critical Care

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Purpose of review:It is recognised that the quality of CPR is an important predictor of outcome from cardiac arrest yet studies consistently demonstrate that the quality of CPR performed in real life is frequently sub-optimal. Mechanical chest compression devices provide an alternative to manual CPR. This review will consider the evidence and current indications for the use of these devices. Recent findings:Physiological and animal data suggest that mechanical chest compression devices are more effective than manual CPR. However there is no high quality evidence showing improved outcomes in humans. There are specific circumstances where it may not be possible to perform manual CPR effectively e.g. during ambulance transport to hospital, en-route to and during cardiac catheterisation, prior to organ donation and during diagnostic imaging where using these devices may be advantageous. Summary:There is insufficient evidence to recommend the routine use of mechanical chest compression devices. There may be specific circumstances when CPR is difficult or impossible where

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Section: Injuries Associated With Mechanical Compression Devicesmentioning

confidence: 99%

Mechanical chest-compression devices: current and future roles

Perkins

Brace

Gates

2010

Current Opinion in Critical Care

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“…12 Second, there is an emerging need for a systematic study of injuries associated with the novel mechanical compression devices that are becoming increasingly popular. 12 Case reports illustrating catastrophic injuries associated with their use have appeared in recent years, [13][14][15][16] but similar injuries have also been described in the context of manual compression 1,[17][18][19][20] and systematic studies are needed.…”

Section: Introductionmentioning

confidence: 99%

Chest Compression Injuries Detected via Routine Post-arrest Care in Patients Who Survive to Admission after Out-of-hospital Cardiac Arrest

Boland¹,

Satterlee²,

Hokanson³

et al. 2014

Prehospital Emergency Care

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Objective. To examine injuries produced by chest compressions in out-of-hospital cardiac arrest (OHCA) patients who survive to hospital admission. Methods. A retrospective cohort study was conducted among 235 consecutive patients who were hospitalized after nontraumatic OHCA in Minnesota between January 2009 and May 2012 (117 survived to discharge; 118 died during hospitalization). Cases were eligible if the patient had received prehospital compressions from an emergency medical services (EMS) provider. One EMS provider in the area was using a mechanical compression device (LUCAS) as standard equipment, so the association between injury and use of mechanical compression was also examined. Prehospital care information was abstracted from EMS run sheets, and hospital records were reviewed for injuries documented during the post-arrest hospitalization that likely resulted from compressions. Results. Injuries were identified in 31 patients (13%), the most common being rib fracture (9%) and intrathoracic hemorrhage (3%). Among those who survived to discharge, the mean length of stay was not statistically significantly different between those with injuries (13.5 days) and those without (10.8 days; p = 0.23). Crude injury prevalence was higher in those who died prior to discharge, had received compressions for >10 minutes (versus ≤10 minutes) and underwent computer tomography (CT) imaging, but did not differ by bystander compressions or use of mechanical compression. After multivariable adjustment, only compression time > 10 min and CT imaging during hospitalization were positively associated with detected injury (OR = 7.86 [95% CI = 1.7-35.9] and 6.30 [95% CI = 2.6-15.5], respectively). Conclusion. In patients who survived OHCA to admission, longer duration of compressions and use of CT during the post-arrest course were associated positively with documented compression injury. Compression-induced injuries detected via routine post-arrest care are likely to be largely insignificant in terms of length of recovery.

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“…Several case reports have described liver injuries related to CPR with both manual12 13 and mechanical14–16 compressions. Three of the cited cases resulted in haemodynamic compromise requiring intervention, with one subsequent death attributed to haemorrhagic shock 15. As manual compressions should always precede mechanical devices, it is impossible to definitively attribute any complication to mechanical compressions.…”

Section: Discussionmentioning

confidence: 99%

Ruptured subcapsular liver haematoma following mechanically-assisted cardiopulmonary resuscitation

Joseph

Freundlich

Abir³

2016

BMJ Case Reports

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SUMMARYA 64-year-old man with a history of ascending aortic surgery and pulmonary embolus presented with shortness of breath. He rapidly decompensated, prompting intubation, after which he lost pulses. Manual resuscitation was initiated immediately, with subsequent use of a LUCAS-2 mechanical compression device. The patient was given bolus thrombolytic therapy and regained pulses after 7 min of CPR. Compressions were reinitiated with the LUCAS-2 twice more during resuscitation over the subsequent hour for brief episodes of PEA. After confirmation of massive pulmonary embolism on CT, the patient underwent interventional radiology-guided ultrasonic catheter placement with local thrombolytic therapy and experienced immediate improvement in oxygenation. He later developed abdominal compartment syndrome, despite cessation of thrombolytic and anticoagulation therapy. Bedside exploratory abdominal laparotomy revealed a ruptured subcapsular haematoma of the liver. The patient's haemodynamics improved following surgery and he was extubated 11 days postarrest with intact neurological function. BACKGROUND

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Fatal complication secondary to mechanical chest compression device

Cited by 20 publications

References 4 publications

Mechanical chest-compression devices: current and future roles

Mechanical chest-compression devices: current and future roles

Chest Compression Injuries Detected via Routine Post-arrest Care in Patients Who Survive to Admission after Out-of-hospital Cardiac Arrest

Ruptured subcapsular liver haematoma following mechanically-assisted cardiopulmonary resuscitation

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