Injuries associated with cardiopulmonary resuscitation in non-survivors after out-of-hospital cardiac arrest (autopsy study)

Czech version

Authors: Lucia Ihnát Rudinská ^1,2; Petr Hejna ³; Margita Smatanová ^1,2; Peter Ihnát ⁴; Igor Dvořáček ^1,2
Authors‘ workplace: Ústav soudního lékařství, FN Ostrava ¹; Katedra intenzivní medicíny a forenzních oborů, Lékařská fakulta Ostravské University ²; Ústav soudního lékařství, LF UK a FN Hradec Králové ³; Katedra chirurgických oborů, Lékařská fakulta Ostravské University ⁴
Published in: Soud Lék., 62, 2017, No. 2, p. 18-21
Category: Original Article

Overview

The aim of the present study is to investigate incidence and seriousness of CPR-associated injuries on a cohort of CPR non-survivors after out-of-hospital cardiac arrest in the Moravian-Silesian region. In total, 80 persons were included in the study within the study period (2012 – 2015). CPR-associated injuries were identified in 75 (93.7 %) persons, multiple injuries were found in 73 persons. Spectrum of identified injuries covered skin injuries of the upper half of the body, head and neck injuries, rare abdominal injuries and very frequent thorax injuries.

Sternal fractures were found in 53 (63.3 %) persons. Rib fractures were identified in 59 (73.0 %) persons; rib fractures were usually multiple (mean number of broken ribs was 7.6 per person). Intra-thoracic injuries were diagnosed in 33 (41.2 %) persons – findings of lung contusions and lacerations, transmural heart contusions, hemothorax and hemopericard. The vast majority of identified intra-thoracic injuries were considered clinically relevant (provided the fact that return of spontaneous circulation had been achieved).

Intraabdominal injuries (liver and spleen injuries) were identified in 15 (18.7 %) of persons. Vast majority of these injuries was clinically irrelevant. We have found clinically serious injuries (spleen rupture and liver dilacerations) in 3 (3.7 %) persons.

Outcomes of our study suggest that CPR-associated injuries are very common, usually multiple, and in some cases they might be even potentially lethal (if return of spontaneous circulation is achieved).

Key words:
cardiopulmonary resuscitation – cardiac arrest – injuries – autopsy study – sternal and rib fractures

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Labels

Anatomical pathology Forensic medical examiner Toxicology

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Article was published in

Forensic Medicine

2017 Issue 2