J Korean Soc Emerg Med.  2020 Oct;31(5):431-439.

Analysis of the cardiopulmonary resuscitation-related complications based on computed tomography

• Oh JH
• Kim HI

Abstract

Objective
High-quality cardiopulmonary resuscitation (CPR) needs to be provided to cardiac arrest victims. The chest compression at a 5-6 cm depth and 100-120 beats per minute are recommended according to the 2015 CPR guidelines. The physical forces to the patient’s chest wall cause inevitable complications. This study analyzed the CPR-related complications based on computed tomography (CT).
Methods
This was a retrospective, single-center study. The study period was from 2009 to 2019. The cardiac arrest victims received the CPR in or out-of-hospital. After the return of spontaneous circulation, CTs were performed on some survivors. The complications detected on CTs were reviewed, and the types and frequencies of complications, age, sex, arrest location, CPR duration, the survival discharge were investigated.
Results
Among 1,357 cardiac arrest patients during the study period, 368 patients were enrolled. The average age was 64.2, and 66.3% were male. The average CPR duration was 24.6 minutes. The most frequent complication was rib fracture (73.6%). Lung contusion (41.3%), hemothorax (22.0%), sternal fracture (19.3%), and retrosternal hemorrhage (13.6%) were also detected. Those with rib fractures, sternal fractures, and retrosternal hemorrhage were older (P<0.001). Those with rib fractures, lung contusion, hemothorax received longer CPR (P=0.032, P=0.003, and P=0.041). Low survival discharge rates were observed in patients with rib fractures, sternal fractures, and pneumothorax (P=0.002, P=0.014, and P=0.016).
Conclusion
The rib fracture, sternal fracture, and retrosternal hemorrhage were frequent in older patients. Those with rib fractures, lung contusion, or hemothorax received the longer CPR. The survival discharge rates were low in the rib fracture, sternal fracture, pneumothorax patients.

Keyword

Cardiopulmonary resuscitation; Heart arrest; Basic cardiac life support; Complication