Deeper chest compression - More complications for cardiac arrest patients?

作者:Hellevuo Heidi*; Sainio Marko; Nevalainen Riikka; Huhtala Heini; Olkkola Klaus T; Tenhunen Jyrki; Hoppu Sanna
来源:Resuscitation, 2013, 84(6): 760-765.
DOI:10.1016/j.resuscitation.2013.02.015

摘要

Aim of the study: Sternal and rib fractures are frequent complications caused by chest compressions during cardiopulmonary resuscitation (CPR). This study aimed to investigate the potential association of CPR-related thoracic and abdominal injuries and compression depth measured with an accelerometer. %26lt;br%26gt;Methods: We analysed the autopsy records, CT scans or chest radiographs of 170 adult patients, suffering in-hospital cardiac arrest at the Tampere University Hospital during the period 2009-2011 to investigate possible association of chest compressions and iatrogenic injuries. The quality of manual compressions during CPR was recorded on a Philips, HeartStart MRx Q-CPR (TM)-defibrillator. %26lt;br%26gt;Results: Patients were 110 males and 60 females. Injuries were found in 36% of male and 23% of female patients. Among male patients CPR-related injuries were associated with deeper mean - and peak compression depths (p %26lt; 0.05). No such association was observed in women. The frequency of injuries in mean compression depth categories %26lt;5, 5-6 and %26gt;6 cm, was 28%, 27% and 49% (p = 0.06). Of all patients 27% sustained rib fractures, 11% sternal fracture and eight patients had haematomas/ruptures in the myocardium. In addition, we observed one laceration of the stomach without bleeding, one ruptured spleen, one mediastinal haemorrhage and two pneumothoraxes. %26lt;br%26gt;Conclusion: The number of iatrogenic injuries in male patients was associated with chest compressions during cardiopulmonary resuscitation increased as the measured compression depth exceeded 6 cm. While there is an increased risk of complications with deeper compressions it is important to realize that the injuries were by and large not fatal.

  • 出版日期2013-6