Traumatic injuries after manual and automatic mechanical compression during cardiopulmonary resuscitation, a retrospective cohort study
Introduction: Chest compressions during advanced cardiac life support is a life-saving, potential harmful procedure with high incidence of severe and life-threatening injuries. Previous studies suggest a possible correlation between the increased incidence of chest and/or abdominal trauma and the us...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Resuscitation Plus |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S266652042300108X |
| _version_ | 1797429656552472576 |
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| author | Thierry Preda Matteo Nafi Michele Villa Tiziano Cassina |
| author_facet | Thierry Preda Matteo Nafi Michele Villa Tiziano Cassina |
| author_sort | Thierry Preda |
| collection | DOAJ |
| description | Introduction: Chest compressions during advanced cardiac life support is a life-saving, potential harmful procedure with high incidence of severe and life-threatening injuries. Previous studies suggest a possible correlation between the increased incidence of chest and/or abdominal trauma and the use of automatic mechanical compression devices. Methods: An observational monocentric retrospective cohort study was conducted including all patients admitted to our Intensive Care Unit suffering from out-of-hospital cardiac arrest (OHCA) in Canton Ticino (Switzerland) from 2012 to 2021. The primary endpoint was to describe any resuscitation-related body injury. The secondary endpoints were to explore possible predictors of cardiopulmonary resuscitation (CPR) related injuries and their association with the 30-day mortality. Results: We included 335 patients, 287 treated with manual chest compressions, 48 mechanically assisted. 55.5% of all resuscitated patients presented severe, or life-threatening lesions. Skeletal and thoracic injuries were the most frequent lesions followed by abdominal injuries. Mechanical assisted resuscitated patients presented higher risk of bleeding (OR 5.9; 95% CI 2.9–11.6) and increased CPR-related injuries (aOR 6.2; 95% CI 2.5–15.4) compared to standard manual chest compressions. In particular higher number of extra-thoracic and life-threatening lesions were described among the mechanical assisted CPR group. Patients with life-threatening had statistically significant higher mortality at 30-days compared to the severe and lesion’s free cohort. Conclusion: Traumatic lesions occurred frequently after chest compression and their severity was associated with increased 30-day mortality. Mechanical devices, compared to manual chest compression, appear to be more harmful and may play a role in causing body lesions and hemorrhagic events. |
| first_indexed | 2024-03-09T09:16:19Z |
| format | Article |
| id | doaj.art-e4e2ae428813428ca1904bc79cdaa123 |
| institution | Directory Open Access Journal |
| issn | 2666-5204 |
| language | English |
| last_indexed | 2024-03-09T09:16:19Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Resuscitation Plus |
| spelling | doaj.art-e4e2ae428813428ca1904bc79cdaa1232023-12-02T07:06:52ZengElsevierResuscitation Plus2666-52042023-12-0116100465Traumatic injuries after manual and automatic mechanical compression during cardiopulmonary resuscitation, a retrospective cohort studyThierry Preda0Matteo Nafi1Michele Villa2Tiziano Cassina3Università della Svizzera Italiana (USI), Lugano, Switzerland; Department of Cardiac Anesthesiology and Intensive Care, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, SwitzerlandDepartment of Cardiac Anesthesiology and Intensive Care, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, SwitzerlandDepartment of Cardiac Anesthesiology and Intensive Care, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland; Corresponding author at: Department of Intensive Care, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland.Università della Svizzera Italiana (USI), Lugano, Switzerland; Department of Cardiac Anesthesiology and Intensive Care, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, SwitzerlandIntroduction: Chest compressions during advanced cardiac life support is a life-saving, potential harmful procedure with high incidence of severe and life-threatening injuries. Previous studies suggest a possible correlation between the increased incidence of chest and/or abdominal trauma and the use of automatic mechanical compression devices. Methods: An observational monocentric retrospective cohort study was conducted including all patients admitted to our Intensive Care Unit suffering from out-of-hospital cardiac arrest (OHCA) in Canton Ticino (Switzerland) from 2012 to 2021. The primary endpoint was to describe any resuscitation-related body injury. The secondary endpoints were to explore possible predictors of cardiopulmonary resuscitation (CPR) related injuries and their association with the 30-day mortality. Results: We included 335 patients, 287 treated with manual chest compressions, 48 mechanically assisted. 55.5% of all resuscitated patients presented severe, or life-threatening lesions. Skeletal and thoracic injuries were the most frequent lesions followed by abdominal injuries. Mechanical assisted resuscitated patients presented higher risk of bleeding (OR 5.9; 95% CI 2.9–11.6) and increased CPR-related injuries (aOR 6.2; 95% CI 2.5–15.4) compared to standard manual chest compressions. In particular higher number of extra-thoracic and life-threatening lesions were described among the mechanical assisted CPR group. Patients with life-threatening had statistically significant higher mortality at 30-days compared to the severe and lesion’s free cohort. Conclusion: Traumatic lesions occurred frequently after chest compression and their severity was associated with increased 30-day mortality. Mechanical devices, compared to manual chest compression, appear to be more harmful and may play a role in causing body lesions and hemorrhagic events.http://www.sciencedirect.com/science/article/pii/S266652042300108XOut-of-hospital cardiac arrestCardiopulmonary resuscitationResuscitation complicationsRib fractureMechanical cardiopulmonary resuscitationTraumatic injuries |
| spellingShingle | Thierry Preda Matteo Nafi Michele Villa Tiziano Cassina Traumatic injuries after manual and automatic mechanical compression during cardiopulmonary resuscitation, a retrospective cohort study Resuscitation Plus Out-of-hospital cardiac arrest Cardiopulmonary resuscitation Resuscitation complications Rib fracture Mechanical cardiopulmonary resuscitation Traumatic injuries |
| title | Traumatic injuries after manual and automatic mechanical compression during cardiopulmonary resuscitation, a retrospective cohort study |
| title_full | Traumatic injuries after manual and automatic mechanical compression during cardiopulmonary resuscitation, a retrospective cohort study |
| title_fullStr | Traumatic injuries after manual and automatic mechanical compression during cardiopulmonary resuscitation, a retrospective cohort study |
| title_full_unstemmed | Traumatic injuries after manual and automatic mechanical compression during cardiopulmonary resuscitation, a retrospective cohort study |
| title_short | Traumatic injuries after manual and automatic mechanical compression during cardiopulmonary resuscitation, a retrospective cohort study |
| title_sort | traumatic injuries after manual and automatic mechanical compression during cardiopulmonary resuscitation a retrospective cohort study |
| topic | Out-of-hospital cardiac arrest Cardiopulmonary resuscitation Resuscitation complications Rib fracture Mechanical cardiopulmonary resuscitation Traumatic injuries |
| url | http://www.sciencedirect.com/science/article/pii/S266652042300108X |
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