24 Injuries following mechanical cardiac massage with a piston-type device. (16th April 2018)

• Record Type: Journal Article
• Authors: Milling, L; Astrup, BS; Mikkelsen, S
• Is Part Of: BMJ open. Volume 8:Supplement 1(2018)
• Page Start: A9
• Page End: A9
• Publication Date: 2018-04-16
• Subjects: Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2018-EMS.24
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : 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. References: . 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 Funding: None