Bulletin of the National Research Centre (Apr 2023)

Partial detachment of the aorta: a fatal complication of CPR chest compressions

  • Michał Szemień,
  • Bartosz Burchardt,
  • Klaudia Dolińska-Kaczmarek,
  • Zbigniew Żaba,
  • Czesław Żaba

DOI
https://doi.org/10.1186/s42269-023-01023-y
Journal volume & issue
Vol. 47, no. 1
pp. 1 – 4

Abstract

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Abstract Background Partial aorta detachment is a rare and fatal complication of mechanical chest compression. Case presentation The paper describes a patient in cardiac arrest who died despite receiving CPR using mechanical chest compression. After death, an autopsy showed the presence of a partial rupture of the aortic wall in the intra-pericardial section. Discussion In the discussion, for this case, we propose to deepen our knowledge of post-resuscitation complications, which may help to understand the need to maintain the recommended parameters of chest compressions, respond more confidently to changes in the patient's condition during CPR, to interpret the results of bedside examinations better, and to understand the autopsy results better. In our opinion, the best method of diagnosing internal injuries, which we provide with Point-of-Care (POCUS) ultrasound, allows for therapeutic interventions that maximize the chances of spontaneous circulation. Education and skill development are also indispensable aspects of CPR. Particular attention should be paid to the same quality of chest compressions performed. Conclusions As conclusions drawn from the analysis of this case, we propose paying particular attention to the difficulty of explaining changes in the patient's condition during CPR, the widespread use of POCUS, and considering the use of compressions performed by staff in situations where it is possible and safe.

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