Incidence of regurgitation and pulmonary aspiration of gastric contents in survivors from out-of-hospital cardiac arrest.
BACKGROUND
The regurgitation of gastric contents and subsequent pulmonary aspiration remain serious adverse events in cardiac arrest and cardiopulmonary resuscitation. The aim of this study was to determine the association between clinical signs of regurgitation and radiological findings consistent with aspiration in resuscitated out-of-hospital cardiac arrest (OHCA) patients admitted to hospital.


METHODS
The incidence of regurgitation was studied in 182 successfully resuscitated OHCA patients. The inclusion criterion was the restoration of spontaneous circulation after OHCA not caused by trauma or drug overdose.


RESULTS
The incidence of regurgitation was 20%. Regurgitation was associated with radiological findings consistent with aspiration with a high specificity (81%) and a low sensitivity (46%).


CONCLUSIONS
Although there was a strong association between clinical regurgitation and radiological findings consistent with aspiration, our data suggest that regurgitation is not invariably followed by radiological findings compatible with aspiration. Radiological findings consistent with aspiration are relatively infrequent without preceding signs of regurgitation in resuscitated patients.
Virkkunen
I
I
Department of Surgery and Anaesthesiology, Tampere University Hospital, Tampere, Finland. ilkka.virkkunen@uta.fi
Ryynänen
S
S
Kujala
S
S
Vuori
A
A
Piilonen
A
A
Kääriä
J-P
JP
Kähärä
V
V
Pettilä
V
V
Yli-Hankala
A
A
Silfvast
T
T
D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects*; D004632:Emergency Medical Services; D005260:Female; D005764:Gastroesophageal Reflux / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017741:Survivors