Deeper chest compression - more complications for cardiac arrest patients?

Abstract:

AIM OF THE STUDY:Sternal and rib fractures are frequent complications caused by chest compressions during cardiopulmonary resuscitation (CPR). This study aimed to investigate the potential association of CPR-related thoracic and abdominal injuries and compression depth measured with an accelerometer. METHODS:We analysed the autopsy records, CT scans or chest radiographs of 170 adult patients, suffering in-hospital cardiac arrest at the Tampere University Hospital during the period 2009-2011 to investigate possible association of chest compressions and iatrogenic injuries. The quality of manual compressions during CPR was recorded on a Philips, HeartStart MRx Q-CPR™-defibrillator. RESULTS:Patients were 110 males and 60 females. Injuries were found in 36% of male and 23% of female patients. Among male patients CPR-related injuries were associated with deeper mean - and peak compression depths (p<0.05). No such association was observed in women. The frequency of injuries in mean compression depth categories <5, 5-6 and >6 cm, was 28%, 27% and 49% (p=0.06). Of all patients 27% sustained rib fractures, 11% sternal fracture and eight patients had haematomas/ruptures in the myocardium. In addition, we observed one laceration of the stomach without bleeding, one ruptured spleen, one mediastinal haemorrhage and two pneumothoraxes. CONCLUSION:The number of iatrogenic injuries in male patients was associated with chest compressions during cardiopulmonary resuscitation increased as the measured compression depth exceeded 6 cm. While there is an increased risk of complications with deeper compressions it is important to realize that the injuries were by and large not fatal.

journal_name

Resuscitation

journal_title

Resuscitation

authors

Hellevuo H,Sainio M,Nevalainen R,Huhtala H,Olkkola KT,Tenhunen J,Hoppu S

doi

10.1016/j.resuscitation.2013.02.015

subject

Has Abstract

pub_date

2013-06-01 00:00:00

pages

760-5

issue

6

eissn

0300-9572

issn

1873-1570

pii

S0300-9572(13)00141-X

journal_volume

84

pub_type

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