D Smekal1, E Lindgren2, H Sandler3, J Johansson2, S Rubertsson2. 1. Department of Surgical Sciences, Anaesthesiology & Intensive Care, Uppsala University, S-751 85 Uppsala, Sweden. Electronic address: dsmekal@gmail.com. 2. Department of Surgical Sciences, Anaesthesiology & Intensive Care, Uppsala University, S-751 85 Uppsala, Sweden. 3. Department of Surgical Sciences, Forensic Medicine, Uppsala University, S-751 85 Uppsala, Sweden; National Board of Forensic Medicine, S-751 40 Uppsala, Sweden.
Abstract
AIM: The reported incidence of injuries due to cardiopulmonary resuscitation using manual chest compressions (manual CPR) varies greatly. Our aim was to elucidate the incidence of CPR-related injuries by manual chest compressions compared to mechanical chest compressions with the LUCAS device (mechanical CPR) in non-survivors after out-of-hospital cardiac arrest. METHODS: In this prospective multicentre trial, including 222 patients (83 manual CPR/139 mechanical CPR), autopsies were conducted after unsuccessful CPR and the results were evaluated according to a specified protocol. RESULTS: Among the patients included, 75.9% in the manual CPR group and 91.4% in the mechanical CPR group (p=0.002) displayed CPR-related injuries. Sternal fractures were present in 54.2% of the patients in the manual CPR group and in 58.3% in the mechanical CPR group (p=0.56). Of the patients in the manual CPR group, there were 64.6% with at least one rib fracture versus 78.8% in the mechanical CPR group (p=0.02). The median number of rib fractures among patients with rib fractures was 7 in the manual CPR group and 6 in the mechanical CPR group. No CPR-related injury was considered to be the cause of death. CONCLUSION: In patients with unsuccessful CPR after out-of-hospital cardiac arrest, rib fractures were more frequent after mechanical CPR but there was no difference in the incidence of sternal fractures. No injury was deemed fatal by the pathologist.
RCT Entities:
AIM: The reported incidence of injuries due to cardiopulmonary resuscitation using manual chest compressions (manual CPR) varies greatly. Our aim was to elucidate the incidence of CPR-related injuries by manual chest compressions compared to mechanical chest compressions with the LUCAS device (mechanical CPR) in non-survivors after out-of-hospital cardiac arrest. METHODS: In this prospective multicentre trial, including 222 patients (83 manual CPR/139 mechanical CPR), autopsies were conducted after unsuccessful CPR and the results were evaluated according to a specified protocol. RESULTS: Among the patients included, 75.9% in the manual CPR group and 91.4% in the mechanical CPR group (p=0.002) displayed CPR-related injuries. Sternal fractures were present in 54.2% of the patients in the manual CPR group and in 58.3% in the mechanical CPR group (p=0.56). Of the patients in the manual CPR group, there were 64.6% with at least one rib fracture versus 78.8% in the mechanical CPR group (p=0.02). The median number of rib fractures among patients with rib fractures was 7 in the manual CPR group and 6 in the mechanical CPR group. No CPR-related injury was considered to be the cause of death. CONCLUSION: In patients with unsuccessful CPR after out-of-hospital cardiac arrest, rib fractures were more frequent after mechanical CPR but there was no difference in the incidence of sternal fractures. No injury was deemed fatal by the pathologist.
Authors: Christelle Lardi; Coraline Egger; Robert Larribau; Marc Niquille; Patrice Mangin; Tony Fracasso Journal: Int J Legal Med Date: 2015-01-27 Impact factor: 2.686
Authors: My-Linh Nguyen; Emma Gause; Brianna Mills; Joseph E Tonna; Heidi Alvey; Richard Saczkowski; Brian Grunau; Lance B Becker; David F Gaieski; Scott Youngquist; Kyle Gunnerson; Peter England; Jessica Hamilton; Jenelle Badulak; Samuel P Mandell; Eileen M Bulger; Nicholas J Johnson Journal: Resuscitation Date: 2020-10-12 Impact factor: 5.262