Korean J Crit Care Med.  2014 Aug;29(3):172-176. 10.4266/kjccm.2014.29.3.172.

Interruption of Chest Compression for Central Venous Catheterization during Cardiopulmonary Resuscitation

• Kim YO
• Park HS

• KMID: 1892247
• DOI: http://doi.org/10.4266/kjccm.2014.29.3.172

Abstract

BACKGROUND
Peripheral venous catheterization (PVC) is a less invasive and time consuming technique than central venous catheterization (CVC); however, for patients in circulatory collapse or receiving cardiopulmonary resuscitation (CPR), PVC cannot be achieved easily. CVC can provide not only a more effective administration route for medication, but also important hemodynamic information. Owing to the possibility of CPR interruptions and complications, CVC is recommended only after the failure of PVC. This observational study is aimed to evaluate the risks and benefits of CVC during CPR.
METHODS
This retrospective observational study was performed in the emergency department (ED) of a university hospital. Adult patients without a pulse on arrival were consecutively enrolled if subclavian CVC was performed at the beginning of CPR. Patients who already had an established intravenous route or had severe chest injuries on arrival were excluded. Closed-circuit television was used to evaluate the frequency of compression interruption. The incidence of iatrogenic pneumothorax, an acute mechanical complication associated with subclavian CVC, was investigated using chest X-ray after CPR.
RESULTS
During a 6-month period, 35 patients underwent CPR and 31 of these received subclavian CVC. Among the patients, one patient experienced iatrogenic pneumothorax (3.8%), and 13 CPR interruptions occurred in 10 subjects during subclavian CVC.
CONCLUSIONS
During CPR in 31 patients, one iatrogenic pneumothorax was caused by subclavian CVC, and CPR interruptions were observed in approximately 30% of cases.

Keyword

catheterization, central venous; cardiopulmonary resuscitation

MeSH Terms

Adult
Cardiopulmonary Resuscitation*
Catheterization, Central Venous*
Catheterization, Peripheral
Central Venous Catheters*
Emergency Service, Hospital
Hemodynamics
Humans
Incidence
Observational Study
Pneumothorax
Retrospective Studies
Risk Assessment
Shock
Television
Thoracic Injuries
Thorax*