Risk factors for cardiopulmonary resuscitation‐related injuries sustained during out‐of‐hospital cardiac arrests

Setälä, Piritta; Hellevuo, Heidi; Kämäräinen, Antti; Tirkkonen, Joonas; Hoppu, Sanna

doi:10.1111/aas.13155

Cited by 13 publications

(21 citation statements)

References 29 publications

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“…Rev Assoc Med Bras 2022;68 (10): [1470][1471][1472][1473][1474][1475] Consistent with the literature [16][17][18] , our cases showed an abdominal injury rate of 4.8%, including liver pericapsular haematoma and pneumoperitoneum in 2 and 1 of 29 patients with thoracoabdominal injury associated with CPR.…”

Section: Discussionsupporting

confidence: 82%

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Relationship between measures of thoracic diameter and cardiopulmonary resuscitation-induced thoracoabdominal injury

Ümit

Söğüt

et al. 2022

Rev. Assoc. Med. Bras.

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OBJECTIVE:We investigated the relationship between thoracic diameters and chest compression-related thoracoabdominal injury in patients with non-traumatic out-of-hospital cardiac arrest who had a return of spontaneous circulation after cardiopulmonary resuscitation. METHODS: A total of 63 consecutive adult non-traumatic out-of-hospital cardiac arrest patients were enrolled in this prospective study. Computed tomography was performed on each patient and the anteroposterior diameter, skin-to-skin anteroposterior diameter, and transverse diameter of the chest were measured. Patients were divided into two groups based on the presence or absence of cardiopulmonary resuscitation-related thoracoabdominal injury. Age, sex, and duration of cardiopulmonary resuscitation, anteroposterior diameter, skin-to-skin anteroposterior diameter, and transverse diameter were compared between the groups. The primary outcome was the relationship between thoracic diameters and cardiopulmonary resuscitation-induced thoracoabdominal injuries. RESULTS: Thoracoabdominal injuries were detected in 46% (n=29) of the patients and consisted of rib fractures in 22 (34.9%) patients, pulmonary contusion in 7 (11.1%), and sternal fracture in 3 (4.8%) patients. There were no significant differences in cardiopulmonary resuscitation duration between patients with and without thoracoabdominal injuries (p=0.539). Similarly, there were no significant differences in anteroposterior diameter, skin-to-skin anteroposterior diameter, or transverse diameter between patient groups (p=0. 978, p=0.730, and p=0.146, respectively) or between patients who died within the first 28 days and those who survived for longer than 28 days (p=0.488, p=0.878, and p=0.853, respectively). CONCLUSION: The iatrogenic thoracoabdominal injuries caused by cardiopulmonary resuscitation performed according to the cardiopulmonary resuscitation guidelines were independent of thoracic diameters. Therefore, the cardiac compression depth of 5-6 cm recommended by the current cardiopulmonary resuscitation guidelines is reliable for patients with different thoracic diameters.

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Section: Discussionsupporting

confidence: 82%

“…The 2020 AHA and 2021 ERC guidelines limit the depth of each compression in CPR to 5-6 cm 2,4 . However, recent studies suggested that CPR may be associated with severe thoracoabdominal injuries [9][10][11] . Thoracic injuries due to chest compressions cause significant mortality and morbidity 6,7,12 .…”

Section: Discussionmentioning

confidence: 99%

Relationship between measures of thoracic diameter and cardiopulmonary resuscitation-induced thoracoabdominal injury

Ümit

Söğüt

et al. 2022

Rev. Assoc. Med. Bras.

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“…Cardiopulmonary resuscitation can cause chest injuries— Table 3 [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ]. The incidence of injury is variable and can reach up to 100%, as demonstrated in a study by Jang SJ et al Differences in the number of injuries diagnosed may be related to the sensitivity of specific diagnostic tests.…”

Section: Resultsmentioning

confidence: 99%

“…The impact of using a mechanical device during CPR is not clear. Studies by Smekal et al and Freiberg et al, comparing manual vs. mechanical chest compressions showed that rib fractures were more common after the use of a mechanical device [ 35 , 36 ]. In contrast, in the study by Kralij et al and Canakci et al, no significant difference was observed in terms of complications in patients who received mechanical compression compared to those who received only manual compression [ 29 , 43 ].…”

Section: Resultsmentioning

confidence: 99%

Analgesic Use in Patients during Cardio-Pulmonary Resuscitation

Dąbrowski

Lange

Basiński

2023

IJERPH

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Introduction: Cardiopulmonary resuscitation-induced consciousness is a newly recognized phenomenon with an increasing incidence. A return of consciousness during cardiopulmonary resuscitation affects up to 0.9% of cases. Patients may also experience physical pain associated with chest compressions, as most victims of cardiac arrest who are subjected to resuscitative efforts sustain ribs or sternum fractures. Methods: A rapid review was carried out from August 2021 to December 2022. Results: Thirty-two articles were included in the rapid review. Of these, eleven studies focused on the return of consciousness during CPR, and twenty-one on CPR-induced chest injuries. Conclusion: A small number of studies that have dealt with the return of consciousness associated with cardiopulmonary resuscitation made it hard to clearly determine how often this occurs. There were more studies that dealt with chest trauma during resuscitation, but no study considered the use of analgesics. Of note, there was no standardized therapeutic approach as far as the use of analgesics and/or sedatives was considered. This is probably due to the lack of guidelines for analgesic management during cardiopulmonary resuscitation and peri-resuscitative period.

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“…The pathologist reported two such cases, but they were not considered as serious, which correspond with relevant literature. 17 The role of manual chest compressions (performed by lay people, first responders and ambulance crews) before mechanical chest compressions as potential cause of CPR related injuries, is difficult to document. We did not measure the actual force or chest properties (stiffness) in our study.…”

Section: Discussionmentioning

confidence: 99%

Injuries associated with mechanical chest compressions and active decompressions after out-of-hospital cardiac arrest: A subgroup analysis of non-survivors from a randomized study

et al. 2023

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Risk factors for cardiopulmonary resuscitation‐related injuries sustained during out‐of‐hospital cardiac arrests

Abstract: Older age, male gender, and public location were independently associated with CPR-related injuries. The duration of the resuscitation attempts did not affect the incident of injuries.

Cited by 13 publications

References 29 publications

Relationship between measures of thoracic diameter and cardiopulmonary resuscitation-induced thoracoabdominal injury

Relationship between measures of thoracic diameter and cardiopulmonary resuscitation-induced thoracoabdominal injury

Analgesic Use in Patients during Cardio-Pulmonary Resuscitation

Injuries associated with mechanical chest compressions and active decompressions after out-of-hospital cardiac arrest: A subgroup analysis of non-survivors from a randomized study

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