Aim Chest injuries and abdominal injuries as a result of vigorous cardiac compression have caused concern ever since manual cardiopulmonary resuscitation was introduced.1 The same concerns have now been expressed in relation to mech-CPR.2,3 The aim of this study was to investigate injury patterns related to mech-CPR in comparison to manual CPR.
Method During a study period of 15 months, a convenience sample of all patients treated with chest compressions (CC) by the Odense MECU as well as all patients in the Region of Southern Denmark treated with mech-CPR was assessed. Prehospital discharge reports, in-hospital records, and autopsy reports were manually reviewed for indications of injuries related to CC.
Results We included 75 patients receiving mech-CPR and 234 patients receiving manual CPR. The crude analysis showed that mech-CPR posed a significantly higher risk of injuries than manual CPR (p<0.001, Odds-Ratio 3.31, CI: 1.91 to 5.74). When adjusted for duration of CPR this difference waned. Mech-CPR significantly increased the likelihood of soft tissue injuries compared with manual CPR alone. This difference was significant both in a crude analysis and adjusted for duration, age, gender, BMI and anticoagulant therapy (Odds-Ratio 31.87 (CI: 5.82 to 172.83 (p<0.001)). Furthermore, the occurrence of injuries was associated with duration of CC regardless of mech-CPR or manual CPR (Odds-Ratio 1.02 (CI: 1.00 to 1.04 (p=0.02)).
Conclusion Mech-CPR was strongly associated with soft tissue injuries. Prolonged duration of CPR was associated with increased prevalence of injuries. This finding may have implications for future on-scene treatment of patients in cardiac arrest.
. Ihnat Rudinska L, Hejna P, Ihnat P, Tomaskova H, Smatanova M, Dvoracek I. Intra-thoracic injuries associated with cardiopulmonary resuscitation: Frequent and serious. Resuscitation2016;103:66–70.
. Camden JR, Carucci LR. Liver injury diagnosed on computed tomography after use of an automated cardiopulmonary resuscitation device. Emerg Radiol2011;18(5):429–431.
. Joseph JR, Freundlich RE, Abir M. Ruptured subcapsular liver haematoma following mechanically-assisted cardiopulmonary resuscitation. BMJ Case Rep2016;2016.
Conflict of interest None
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