Literature DB >> 23380086

Anatomical structures underneath the sternum in healthy adults and implications for chest compressions.

Prokopis Papadimitriou1, Athanasios Chalkias, Antonis Mastrokostopoulos, Irene Kapniari, Theodoros Xanthos.   

Abstract

OBJECTIVE: Chest compressions are pivotal determinants of successful resuscitation. The aim of our study was to identify the variations of the anatomical structures underneath the sternum and to investigate possible implications for chest compressions.
METHODS: A retrospective study of all patients who underwent a routine chest computed tomography from January 2009 to January 2010 in a tertiary teaching general hospital was performed. The sternum and the area underneath were divided in 2 regions, one consisting of the second and third intercostal spaces, referred to as 2-3 segment, and one consisting of the fourth and fifth intercostal spaces, referred to as 4-6 segment.
RESULTS: During the study period, 677 consecutive scans were analyzed. The most frequent structures beneath 2-3 segment were the left atrium (77.42%) and right atrium (69.82%), followed by the right ventricle (36.64%), left ventricle (35.94%), and left ventricular outflow (31.80%). Underneath 4-6 segment, the most frequent structures were the right ventricle (99.31%) and left ventricle (99.77%), followed by the right atrium (97%), left atrium (96.77%), and left ventricular outflow (36.64%). Interestingly, the difference in occurrence of atria and ventricles in both segments was significant irrespective of sex.
CONCLUSIONS: The occurrence of cardiac chambers under the lower part of the sternum is very high, making it a reasonable position for hand placement during chest compressions. However, optimal hand position may differ with age and among healthy individuals owing to variations in thoracic anatomy.
Copyright © 2013 Elsevier Inc. All rights reserved.

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Year:  2013        PMID: 23380086     DOI: 10.1016/j.ajem.2012.10.023

Source DB:  PubMed          Journal:  Am J Emerg Med        ISSN: 0735-6757            Impact factor:   2.469


  6 in total

1.  Frequency of sternal variations in living individuals.

Authors:  Rustu Turkay; Ercan Inci; Suna Ors; Mustafa Orhan Nalbant; Ilke Ali Gurses
Journal:  Surg Radiol Anat       Date:  2017-04-10       Impact factor: 1.246

2.  Biomechanical response of human rib cage to cardiopulmonary resuscitation maneuvers: Effects of the compression location.

Authors:  Mario Suazo; Joan Herrero; Gerard Fortuny; Dolors Puigjaner; Josep M López
Journal:  Int J Numer Method Biomed Eng       Date:  2022-02-27       Impact factor: 2.648

3.  Radiological assessment of chest compression point and achievable compression depth in cardiac patients.

Authors:  Sverre Nestaas; Knut Haakon Stensæth; Vigdis Rosseland; Jo Kramer-Johansen
Journal:  Scand J Trauma Resusc Emerg Med       Date:  2016-04-22       Impact factor: 2.953

Review 4.  Understanding the Adverse Hemodynamic Effects of Serious Thoracic Injuries During Cardiopulmonary Resuscitation: A Review and Approach Based on the Campbell Diagram.

Authors:  Youcef Azeli; Juan Víctor Lorente Olazabal; Manuel Ignacio Monge García; Alfredo Bardají
Journal:  Front Physiol       Date:  2019-12-03       Impact factor: 4.566

Review 5.  [Basic life support].

Authors:  Theresa M Olasveengen; Federico Semeraro; Giuseppe Ristagno; Maaret Castren; Anthony Handley; Artem Kuzovlev; Koenraad G Monsieurs; Violetta Raffay; Michael Smyth; Jasmeet Soar; Hildigunnur Svavarsdóttir; Gavin D Perkins
Journal:  Notf Rett Med       Date:  2021-06-02       Impact factor: 0.826

Review 6.  A Comprehensive Review of the Sternal Foramina and its Clinical Significance.

Authors:  Paul J Choi; Joe Iwanaga; R Shane Tubbs
Journal:  Cureus       Date:  2017-12-08
  6 in total

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