Mechanical Chest Compressions and Traumatic Complications in Out-of-hospital Cardiac Arrest. Is There a Price to Pay?

Iglésies, Josep; Loma-Osorio, Pablo; Aboal, Jaime; Núñez, María; Brugada, Ramón

doi:10.1016/j.rec.2018.01.019

Cited by 3 publications

(4 citation statements)

References 5 publications

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“…In a study by Koster et al, LUCAS did not cause serious and life-threatening injuries compared to manual compression [ 22 ]. Conversely, in a study by Iglesies et al, traumatic lesions were more common in the mechanical compression group [ 21 ]. In a retrospective cohort study by Koga et al, life-threatening injuries were more common in the mechanical compression group [ 23 ].…”

Section: Discussionmentioning

confidence: 94%

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Computed Tomographic Findings of Injuries After Mechanical and Manual Resuscitation: A Retrospective Study

Çanakçı

Bağçeci

Acar

et al. 2021

Cureus

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IntroductionCardiopulmonary resuscitation (CPR)-related injuries are complications of chest compressions during CPR. This study aimed to investigate the differences and complications between mechanical and manual CPR techniques by using computed tomography (CT). MethodsPatients in whom return of spontaneous circulation was achieved after CPR and thorax CT imaging were performed for diagnostic purposes were included in the study. ResultsA total of 178 non-traumatic cardiac arrest patients were successfully resuscitated and had CT scans in the emergency department. The complications of CPR are sternum fracture, rib fracture, pleural effusion/hemothorax, and pneumothorax. There were no statistically significant differences in terms of age, first complaint, cardiac arrest rhythm, CPR duration, and complications between mechanical and manual CPR. The number of exitus in the emergency department was similar (p=0.638). The discharge from hospital rate was higher in the mechanical CPR group but there was no statistically significant difference (p=0.196). The duration of CPR was associated with the number of rib fractures and lung contusion, but it did not affect other CPR-related chest injuries. ConclusionThere was no significant difference observed in terms of increased complications in patients who received mechanical compression as compared with those who received manual compression. According to our results, mechanical compression does not cause serious complications, and the discharge from hospital rate was higher than for manual CPR; therefore, its use should be encouraged.

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Section: Discussionmentioning

confidence: 94%

“…In our study, the most common complaint in witnessed cardiac arrests was shortness of breath. In a study conducted by Iglesies et al, this complaint was STEMI [ 21 ]. Acute myocardial infarction was more common possibly because out-of-hospital cardiac arrests were evaluated in that study.…”

Section: Discussionmentioning

confidence: 99%

Computed Tomographic Findings of Injuries After Mechanical and Manual Resuscitation: A Retrospective Study

Çanakçı

Bağçeci

Acar

et al. 2021

Cureus

View full text Add to dashboard Cite

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“…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%

“…In a recent scientific letter, routine imaging within the first hours of admission revealed traumatic complications in 10 of the 11 patients who received mechanical chest compressions ( 10 ). Given the potential for serious traumatic complications from mechanical CPR, systematic use of imaging post-resuscitation should be considered.…”

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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Rib fractures and other injuries after cardiopulmonary resuscitation for non-traumatic cardiac arrest: a systematic review and meta-analysis

Van Wijck,

Prins,

Verhofstad

et al. 2024

Eur J Trauma Emerg Surg

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Purpose This study aims to ascertain the prevalence of rib fractures and other injuries resulting from CPR and to compare manual with mechanically assisted CPR. An additional aim was to summarize the literature on surgical treatment for rib fractures following CPR. Design Systematic review and meta-analysis. Data sources Embase, Medline Ovid, Cochrane Central, Web of Science, and Google Scholar. Review methods The databases were searched to identify studies reporting on CPR-related injuries in patients who underwent chest compressions for a non-traumatic cardiopulmonary arrest. Subgroup analysis was conducted to compare the prevalence of CPR-related injuries in manual versus mechanically assisted chest compressions. Studies reporting on surgery for CPR-related rib fractures were also reviewed and summarized. Results Seventy-four studies reporting CPR-related injuries were included encompassing a total of 16,629 patients. Any CPR-related injury was documented in 60% (95% confidence interval [95% CI] 49–71) patients. Rib fractures emerged as the most common injury, with a pooled prevalence of 55% (95% CI 48–62). Mechanically assisted CPR, when compared to manual CPR, was associated with a higher risk ratio for CPR-related injuries of 1.36 (95% CI 1.17–1.59). Eight studies provided information on surgical stabilization of CPR-related rib fractures. The primary indication for surgery was the inability to wean from mechanical ventilation in the presence of multiple rib fractures. Conclusion Rib fractures and other injuries frequently occur in patients who undergo CPR after a non-traumatic cardiopulmonary arrest, especially when mechanical CPR is administered. Surgical stabilization of CPR-related rib fractures remains relatively uncommon. Level of evidence Level III, systematic review and meta-analysis.

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Mechanical Chest Compressions and Traumatic Complications in Out-of-hospital Cardiac Arrest. Is There a Price to Pay?

Cited by 3 publications

References 5 publications

Computed Tomographic Findings of Injuries After Mechanical and Manual Resuscitation: A Retrospective Study

Computed Tomographic Findings of Injuries After Mechanical and Manual Resuscitation: A Retrospective Study

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

Rib fractures and other injuries after cardiopulmonary resuscitation for non-traumatic cardiac arrest: a systematic review and meta-analysis

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