Traumatic injuries after manual and automatic mechanical compression during cardiopulmonary resuscitation, a retrospective cohort study

Thierry Preda; Matteo Nafi; Michele Villa; Tiziano Cassina

Resuscitation Plus (Dec 2023)

Traumatic injuries after manual and automatic mechanical compression during cardiopulmonary resuscitation, a retrospective cohort study

Thierry Preda,
Matteo Nafi,
Michele Villa,
Tiziano Cassina

Affiliations

Thierry Preda: Università della Svizzera Italiana (USI), Lugano, Switzerland; Department of Cardiac Anesthesiology and Intensive Care, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland
Matteo Nafi: Department of Cardiac Anesthesiology and Intensive Care, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland
Michele Villa: Department 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.
Tiziano Cassina: Università della Svizzera Italiana (USI), Lugano, Switzerland; Department of Cardiac Anesthesiology and Intensive Care, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland

Journal volume & issue: Vol. 16
p. 100465

Abstract

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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.

Published in Resuscitation Plus

ISSN: 2666-5204 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine
Website: https://www.journals.elsevier.com/resuscitation-plus

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