Use of whole body CT to detect patterns of CPR-related injuries after sudden cardiac arrest
- 450 Downloads
Aims and objectives
We have recently implemented a dedicated sudden cardiac arrest (SCA) - whole-body computed tomography (WBCT) protocol to evaluate SCA patients with return of spontaneous circulation (ROSC) following cardiopulmonary resuscitation (CPR). The aim of this study is to evaluate the number and pattern of CPR-related injuries in ROSC patients with SCA-WBCT.
Methods and materials
Single-centre retrospective review of 39 patients (13 female; 20 male, mean age 51.8 years) with non-traumatic, out-of-hospital SCA and ROSC and evaluation with dedicated SCA-WBCT over a 10-month period.
In-hospital mortality was 54%. CPR-related injuries were detected in 85% (33/39).
Chest injuries were most common on WBCT: 85% (33) subjects had rib fractures (mean of 8.5 fractures/subject); 31% (12) sternal fractures; 13% (5) mediastinal haematoma; 10% (4) pneumothorax; 8% (3) pneumomediastinum and 3% (1) haemothorax. Three subjects (8%) had abdominal injuries on WBCT, including one hepatic haematoma with active haemorrhage.
CPR-related injuries on WBCT after ROSC are common, with serial rib fractures detected most commonly. An unexpectedly high rate of abdominal injuries was detected on SCA-WBCT. Radiologists need to be attuned to the spectrum of CPR-related injuries in WBCT, including abdominal injuries and subtle rib fractures.
• CPR frequently causes injuries.
• Radiologists should be aware of the spectrum of CPR related injuries.
• Rib fractures are frequent and radiologic findings often subtle.
• Clinically unexpected abdominal injuries may be present.
KeywordsCardiopulmonary resuscitation Tomography, X-Ray computed Wounds and injuries Emergencies Radiology
Scientific paper was presented at ECR 2017 (17-P-1685-ECR).
Compliance with ethical standards
The scientific guarantor of this publication is Ken F. Linnau, MD, MS.
Conflict of interest
The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
This study was partially supported by the Institute of Translational Health Science (ITHS) (grant UL1 RR025014 from NCRR/NIH).
Statistics and biometry
No complex statistical methods were necessary for this paper.
Written informed consent was waived by the Institutional Review Board.
Institutional Review Board approval was obtained.
• performed at one institution.
- 1.Kleinman ME, Brennan EE, Goldberger ZD, et al. Part 5: Adult Basic Life Support and Cardiopulmonary Resuscitation Quality: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. In: Vol 132. American Heart Association, Inc.; 2015:S414-S435Google Scholar
- 23.Bonnes JL, Brouwer MA, Navarese EP et al (2016) Manual cardiopulmonary resuscitation versus CPR including a mechanical chest compression device in out-of-hospital cardiac arrest: a comprehensive meta-analysis from randomized and observational studies. Ann Emerg Med 67:349–360.e3CrossRefGoogle Scholar