No difference in autopsy detected injuries in cardiac arrest patients treated with manual chest compressions compared with mechanical compressions with the LUCAS device--a pilot study.
OBJECTIVE
To compare the variety and incidence of internal injuries after manual and mechanical chest compressions during CPR.


METHODS
In a prospective pilot study conducted in two Swedish cities, 85 patients underwent autopsy after unsuccessful resuscitation attempts with manual or mechanical chest compressions, the latter with the LUCAS device. Autopsy was performed and the results were evaluated according to a specified protocol.


RESULTS
No injuries were found in 26/47 patients in the manual group and in 16/38 patients in the LUCAS group (p=0.28). Sternal fracture was present in 10/47 in the manual group and 11/38 in the LUCAS group (p=0.46), and there were multiple rib fractures (> or =3 fractures) in 13/47 in the manual group and in 17/38 in the LUCAS group (p=0.12). Bleeding in the ventral mediastinum was noted in 2/47 and 3/38 in the manual and LUCAS groups respectively (p=0.65), retrosternal bleeding in 1/47 and 3/38 (p=0.32), epicardial bleeding in 1/47 and 4/38 (p=0.17), and haemopericardium in 4/47 and 3/38 (p=1.0) respectively. One patient in the LUCAS group had a small rift in the liver and one patient in the manual group had a rift in the spleen. These injuries were not considered to have contributed to the patient's death.


CONCLUSIONS
Mechanical chest compressions with the LUCAS device appear to be associated with the same variety and incidence of injuries as manual chest compressions.
Smekal
David
D
Department of Surgical Sciences - Anaesthesiology & Intensive Care, Uppsala University, SE-751 85 Uppsala, Sweden. david.smekal@akademiska.se
Johansson
Jakob
J
Huzevka
Tibor
T
Rubertsson
Sten
S
D000368:Aged; D001344:Autopsy; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D005260:Female; D050723:Fractures, Bone / Q000209:etiology; D006323:Heart Arrest / Q000628:therapy*; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D012253:Rib Fractures / Q000209:etiology; D013249:Sternum / Q000293:injuries; D013898:Thoracic Injuries / Q000209:etiology*