Trauma with CPR Based on Autopsy Reports after the 2015 ERC Guidelines

Trauma with CPR Based on Autopsy Reports after the 2015 ERC Guidelines
Since the 2015 Resuscitation Guidelines were developed, injuries caused by cardiopulmonary resuscitation (CPR) have not been evaluated. Therefore, for a study, researchers sought to analyze the influence of the 2015 European Resuscitation Council (ERC) recommendations on the objective evaluation of injuries and to report the frequency and severity of CPR-related injuries.

The retrospective multicenter investigation examined autopsy records from individuals who had CPR. The Abbreviated Injury Scale (AIS) was used to evaluate the most serious injuries objectively, and the New Injury Severity Score (NISS) was used to rank all injuries.

Patient traits and case information from the 628 autopsy reports examined were allocated as follows: Male sex was 71.1%; median age was 67; the out-of-hospital cardiac arrest was 89.2%, and bystander CPR was performed in 56.8% of cases. The following injuries were caused by CPR: ribs (94.6%), lungs (9.9%), sternum (62.4%), liver (2.5%), and spleen (1.8%). The frequency of bystander-performed CPR and the degree of injury were comparable to those of CPR exclusively performed by trained experts. The compressions performed manually vs. mechanically were the same. Although their injuries occurred at a comparable rate to men’s, female injuries were substantially more serious (P=0.01) and were older (P=0.0001). Patients with life-threatening injuries displayed a baseline profile comparable to healthy individuals. The most serious injury’s median score (per AIS) was 3, while the NISS-low risk of fatal injury score (median of all injuries) was 13.

Although just 3% of instances included life-threatening injuries, CPR-related injuries were common. No distinctions were made between patients revived by experts or bystanders, mechanical chest devices, or manual resuscitation. Similar injuries were discovered compared to research based on the 2010 criteria, but more rib fractures, less damage to visceral organs, and fewer life-threatening injuries were noted.