title: Traumatic injuries after mechanical cardiopulmonary resuscitation (LUCAS2): a forensic autopsy study.
abstract: OBJECTIVE
  The aim of our study was to compare traumatic injuries observed after cardiopulmonary resuscitation (CPR) by means of standard (manual) or assisted (mechanical) chest compression by Lund University Cardiopulmonary Assist System, 2nd generation (LUCAS2) device.
  
  
  METHODS
  A retrospective study was conducted including cases from 2011 to 2013, analysing consecutive autopsy reports in two groups of patients who underwent medicolegal autopsy after unsuccessful CPR. We focused on traumatic injuries from dermal to internal trauma, collecting data according to a standardised protocol.
  
  
  RESULTS
  The study group was comprised of 26 cases, while 32 cases were included in the control group. Cardiopulmonary resuscitation performed by LUCAS2 was longer than manual CPR performed in control cases (study group: mean duration 51.5 min; controls 29.4 min; p = 0.004). Anterior chest lesions (from bruises to abrasions) were described in 18/26 patients in the LUCAS2 group and in 6/32 of the control group. A mean of 6.6 rib fractures per case was observed in the LUCAS2 group, but this was only 3.1 in the control group (p = 0.007). Rib fractures were less frequently observed in younger patients. The frequency of sternal factures was similar in both groups. A few trauma injuries to internal organs (mainly cardiac, pulmonary and hepatic bruises), and some petechiae (study 46%; control 41 %; p = 0.79) were recorded in both groups.
  
  
  CONCLUSIONS
  LUCAS™2-CPR is associated with more rib fractures than standard CPR. Typical round concentric skin lesions were observed in cases of mechanical reanimation. No life-threatening injuries were reported. Petechiae were common findings.
authors: University Centre of Legal Medicine, Geneva University Hospitals, Rue Michel-Servet 1, 1211, Geneva 4, Switzerland, christelle.lardi@hcuge.ch.
authors: Christelle
authors: C
authors: Lardi
authors: Coraline
authors: C
authors: Egger
authors: Robert
authors: R
authors: Larribau
authors: Marc
authors: M
authors: Niquille
authors: Patrice
authors: P
authors: Mangin
authors: Tony
authors: T
authors: Fracasso
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects* / Q000295:instrumentation*; D016022:Case-Control Studies; D003288:Contusions / Q000209:etiology / Q000473:pathology; D005260:Female; D049429:Forensic Pathology; D050723:Fractures, Bone / Q000209:etiology / Q000473:pathology; D006335:Heart Injuries / Q000209:etiology / Q000473:pathology; D006801:Humans; D008099:Liver / Q000293:injuries / Q000473:pathology; D055370:Lung Injury / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011693:Purpura / Q000209:etiology / Q000473:pathology; D012189:Retrospective Studies; D012253:Rib Fractures / Q000209:etiology / Q000473:pathology; D013249:Sternum / Q000293:injuries / Q000473:pathology; D013997:Time Factors; D055815:Young Adult