[Specific risks of active compression-decompression in cardiopulmonary resuscitation: a case report].
Circulatory effects of cardiopulmonary resuscitation with active compression-decompression (CPR-ACD) are superior to the conventional technique. Decompression, thoracic expansion and a corresponding suction effect obviously improves cardiac preload. Due to significant or unphysiological thoracic expansion, thorax, diaphragma, and epigastrium are exposed to considerable traction powers. In a patient with fulminant pulmonary embolism, conventional cardiac massage and ACD were maintained during 65 minutes with simultaneous systemic thrombolytic therapy. After CPR, the patient developed a massive haemorrhagic shock. During emergency laparotomy, significant adhesions of upper abdominal organs with serious injuries of spleen and liver were found. Traction powers during CPR-ACD in combination with abdominal adhesions are considered responsible. Until improved outcome of CPR-ACD is demonstrated in larger clinical investigations, at least initially conventional cardiac massage should be preferred before the ACD-technique is used. Special attention to patients with a history of upper abdominal operations or chronic inflammatory lung diseases is mandatory.
Adams
H A
HA
Abteilung für Anästhesie und Intensivmedizin, Marienkrankenhaus Trier-Ehrang.
Hempelmann
G
G
Beigl
B
B
Schmitz
C S
CS
D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D003131:Combined Modality Therapy; D003664:Decompression; D017809:Fatal Outcome; D006801:Humans; D007720:Knee Prosthesis; D008099:Liver / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery; D011183:Postoperative Complications / Q000503:physiopathology / Q000601:surgery / Q000628:therapy; D011312:Pressure / Q000009:adverse effects; D011655:Pulmonary Embolism / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D012307:Risk Factors; D012771:Shock, Hemorrhagic / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D013154:Spleen / Q000293:injuries*; D015912:Thrombolytic Therapy; D000267:Tissue Adhesions
Spezifische Risiken der aktiven Kompression-Dekompression bei kardiopulmonaler Reanimation: Ein Fallbericht.