title: Intravascular gas in multiple organs detected by postmortem computed tomography: effect of prolonged cardiopulmonary resuscitation on organ damage in patients with cardiopulmonary arrest.
abstract: A 76-year-old woman was found in cardiopulmonary arrest with her head submerged in water in a bathtub. Despite cardiopulmonary resuscitation (CPR) for over 1 h by professional emergency technicians and medical doctors, the patient died. Postmortem computed tomography revealed not only pulmonary edema associated with drowning but also the presence of intravascular gas in the pulmonary artery, liver, kidneys, heart (right ventricle), and brain. It was speculated that intravascular gas was generated and spread to multiple organs during CPR procedures via the alimentary tract and lungs, which had been damaged by ischemia after cardiopulmonary arrest. Prolonged CPR procedures may involve the risk of additional organ damage and systemic air emboli.
authors.affiliation: Department of Internal Medicine, Tsurugi Municipal Hospital, Hakusan, Japan. t-zenda@tsurugihp.jp
authors.forename: Takahiro
authors.initials: T
authors.lastname: Zenda
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Takayama
authors.forename: Masaji
authors.initials: M
authors.lastname: Miyamoto
authors.forename: Shizuko
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Tamao
authors.initials: T
authors.lastname: Endo
authors.forename: Hideo
authors.initials: H
authors.lastname: Inaba
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects*; D004332:Drowning; D004618:Embolism, Air / Q000000981:diagnostic imaging* / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D011180:Postmortem Changes; D011654:Pulmonary Edema / Q000000981:diagnostic imaging* / Q000209:etiology; D014057:Tomography, X-Ray Computed / Q000379:methods*