Comparing thoracoabdominal injuries of manual versus load-distributing band cardiopulmonary resuscitation
| Autor: | Alireza R. Bayat, Johannes G. van der Hoeven, Marleen H. van Wely, Dennis Bosboom, Lianne J P Sonnemans, Willemijn M. Klein, Marc A. Brouwer, Aniek R.C. Bruinen, Mathias Prokop |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
medicine.medical_specialty Rib Fractures Thoracic Injuries medicine.medical_treatment education Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] 030204 cardiovascular system & hematology Return of spontaneous circulation Hemopericardium 03 medical and health sciences 0302 clinical medicine All institutes and research themes of the Radboud University Medical Center Pneumoperitoneum medicine Humans Cardiopulmonary resuscitation Retrospective Studies business.industry Other Research Radboud Institute for Health Sciences [Radboudumc 0] Pericardial fluid 030208 emergency & critical care medicine Odds ratio medicine.disease Hemothorax Cardiopulmonary Resuscitation Surgery Heart Arrest lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] Pneumothorax Emergency Medicine business Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] |
| Zdroj: | European Journal of Emergency Medicine, 27, 3, pp. 197-201 European Journal of Emergency Medicine, 27, 197-201 |
| ISSN: | 1473-5695 0969-9546 |
| Popis: | OBJECTIVE To identify and compare manual and load-distributing band (LDB) cardiopulmonary resuscitation (CPR)-related injuries. METHODS Retrospective observational cohort study. Adult, nontraumatic deaths with a postmortem computed tomography scan (PMCT) performed were classified into two groups: deceased after LDB CPR or after manual CPR. PMCT scans were reviewed for thoracoabdominal injuries such as fractures, pneumothorax and hemorrhage. The injuries between groups were compared. RESULTS LDB CPR (n = 43) showed increased incidences of posterior rib fractures (53 vs 18%, P = 0.006), pneumothorax (23 vs 4%, P = 0.04) and more pericardial fluid (median 12 vs 6 mm, P = 0.002) compared with manual CPR (n = 29). Multivariable regression analysis revealed that LDB CPR was significantly associated with posterior rib fractures [odds ratio (OR) 5.37, 95% confidence interval (CI): 1.44-20.09, P = 0.01). Pneumothorax (OR 6.80, 95% CI: 0.73-62.99, P = 0.09) and the amount of pericardial fluid (OR 3.40, 95% CI: 0.20-56.32) were not significantly associated with LDB CPR. No significant difference was found for anterolateral rib fractures, sternal fractures, vertebral fractures, pleural fluid, hemothorax, hemopericardium, pneumoperitoneum, perihepatic, perisplenic and perirenal hemorrhage. CONCLUSION Rib fractures, sternal fractures, hemothorax and hemopericardium are common CPR-related injuries. LDB CPR is significantly associated with more posterior rib fractures and a trend toward more pneumothoraces is observed when compared with manual CPR. This knowledge is important for caretakers in the case of ongoing CPR, as a pneumothorax may attribute to not achieving persistent return of spontaneous circulation, and to improve postresuscitation care of survivors. |
| Databáze: | OpenAIRE |
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