Traumatic injuries after manual and automatic mechanical compression during cardiopulmonary resuscitation, a retrospective cohort study

• 發表在: Resuscitation Plus
• Main Authors: Thierry Preda, Matteo Nafi, Michele Villa, Tiziano Cassina
• 格式: Article
• 語言: 英语
• 出版: Elsevier 2023-12-01
• 主題: Out-of-hospital cardiac arrest; Cardiopulmonary resuscitation; Resuscitation complications; Rib fracture; Mechanical cardiopulmonary resuscitation; Traumatic injuries
• 在線閱讀: http://www.sciencedirect.com/science/article/pii/S266652042300108X

Introduction: Chest compressions during advanced cardiac life support is a life-saving, potential harmful procedure with high incidence of severe and life-threatening injuries. Previous studies suggest a possible correlation between the increased incidence of chest and/or abdominal trauma and the use of automatic mechanical compression devices. Methods: An observational monocentric retrospective cohort study was conducted including all patients admitted to our Intensive Care Unit suffering from out-of-hospital cardiac arrest (OHCA) in Canton Ticino (Switzerland) from 2012 to 2021. The primary endpoint was to describe any resuscitation-related body injury. The secondary endpoints were to explore possible predictors of cardiopulmonary resuscitation (CPR) related injuries and their association with the 30-day mortality. Results: We included 335 patients, 287 treated with manual chest compressions, 48 mechanically assisted. 55.5% of all resuscitated patients presented severe, or life-threatening lesions. Skeletal and thoracic injuries were the most frequent lesions followed by abdominal injuries. Mechanical assisted resuscitated patients presented higher risk of bleeding (OR 5.9; 95% CI 2.9–11.6) and increased CPR-related injuries (aOR 6.2; 95% CI 2.5–15.4) compared to standard manual chest compressions. In particular higher number of extra-thoracic and life-threatening lesions were described among the mechanical assisted CPR group. Patients with life-threatening had statistically significant higher mortality at 30-days compared to the severe and lesion’s free cohort. Conclusion: Traumatic lesions occurred frequently after chest compression and their severity was associated with increased 30-day mortality. Mechanical devices, compared to manual chest compression, appear to be more harmful and may play a role in causing body lesions and hemorrhagic events.