Prehospital cardiopulmonary resuscitation with manual or mechanical chest compression: A study of compression-induced injuries

Louise Milling, Birgitte Schmidt Astrup, Søren Mikkelsen*

*Kontaktforfatter for dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Objective: Concerns for iatrogenic injuries associated with cardiopulmonary resuscitation led us to investigate the extent and the pattern of chest compression-related injuries in patients subjected to either mechanical and/or manual cardiac compression. Method: In a retrospective study, we performed a manual review of all prehospital discharge reports, in-hospital records, and autopsy reports for evidence of injuries related to chest compression. We included all patients receiving physician-administrated treatment for out-of-hospital cardiac arrest in the Region of Southern Denmark from 2015 to 2017. Results: Eighty four patients undergoing manual and mechanical chest compression and 353 patients with manual chest compression only were included. Unadjusted, mechanical chest compression as an adjunct was associated with a higher risk of injuries than manual chest compression (P < 0.001, odds ratio, OR 3.10). Adjusted for the duration of compression, this difference waned. Visceral injuries were more frequent in patients receiving mechanical chest compression even when adjusted for the duration of compression, age, sex, body mass index and anticoagulant therapy (P < 0.001, OR 29.84). We found a higher incidence of potentially life-threatening injuries in patients receiving mechanical chest compression. The occurrence of injuries overall was associated with the duration of chest compression (P = 0.02, OR 1.02). Conclusion: Mechanical chest compression as an adjunct to manual chest compression was strongly associated with potentially life-threatening visceral injuries. The duration of chest compression was associated with injury. Our results suggest that mechanical chest compression should only be applied in situations where manual chest compression is unfeasible.

OriginalsprogEngelsk
TidsskriftActa Anaesthesiologica Scandinavica
Vol/bind63
Udgave nummer6
Sider (fra-til)789-795
ISSN0001-5172
DOI
StatusUdgivet - jul. 2019

Fingeraftryk

Wounds and Injuries
Hospital Records
Denmark
Body Mass Index
Retrospective Studies
Odds Ratio
Physicians
Incidence

Bibliografisk note

© 2019 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Citer dette

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title = "Prehospital cardiopulmonary resuscitation with manual or mechanical chest compression: A study of compression-induced injuries",
abstract = "Objective: Concerns for iatrogenic injuries associated with cardiopulmonary resuscitation led us to investigate the extent and the pattern of chest compression-related injuries in patients subjected to either mechanical and/or manual cardiac compression. Method: In a retrospective study, we performed a manual review of all prehospital discharge reports, in-hospital records, and autopsy reports for evidence of injuries related to chest compression. We included all patients receiving physician-administrated treatment for out-of-hospital cardiac arrest in the Region of Southern Denmark from 2015 to 2017. Results: Eighty four patients undergoing manual and mechanical chest compression and 353 patients with manual chest compression only were included. Unadjusted, mechanical chest compression as an adjunct was associated with a higher risk of injuries than manual chest compression (P < 0.001, odds ratio, OR 3.10). Adjusted for the duration of compression, this difference waned. Visceral injuries were more frequent in patients receiving mechanical chest compression even when adjusted for the duration of compression, age, sex, body mass index and anticoagulant therapy (P < 0.001, OR 29.84). We found a higher incidence of potentially life-threatening injuries in patients receiving mechanical chest compression. The occurrence of injuries overall was associated with the duration of chest compression (P = 0.02, OR 1.02). Conclusion: Mechanical chest compression as an adjunct to manual chest compression was strongly associated with potentially life-threatening visceral injuries. The duration of chest compression was associated with injury. Our results suggest that mechanical chest compression should only be applied in situations where manual chest compression is unfeasible.",
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T1 - Prehospital cardiopulmonary resuscitation with manual or mechanical chest compression

T2 - A study of compression-induced injuries

AU - Milling, Louise

AU - Astrup, Birgitte Schmidt

AU - Mikkelsen, Søren

N1 - © 2019 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

PY - 2019/7

Y1 - 2019/7

N2 - Objective: Concerns for iatrogenic injuries associated with cardiopulmonary resuscitation led us to investigate the extent and the pattern of chest compression-related injuries in patients subjected to either mechanical and/or manual cardiac compression. Method: In a retrospective study, we performed a manual review of all prehospital discharge reports, in-hospital records, and autopsy reports for evidence of injuries related to chest compression. We included all patients receiving physician-administrated treatment for out-of-hospital cardiac arrest in the Region of Southern Denmark from 2015 to 2017. Results: Eighty four patients undergoing manual and mechanical chest compression and 353 patients with manual chest compression only were included. Unadjusted, mechanical chest compression as an adjunct was associated with a higher risk of injuries than manual chest compression (P < 0.001, odds ratio, OR 3.10). Adjusted for the duration of compression, this difference waned. Visceral injuries were more frequent in patients receiving mechanical chest compression even when adjusted for the duration of compression, age, sex, body mass index and anticoagulant therapy (P < 0.001, OR 29.84). We found a higher incidence of potentially life-threatening injuries in patients receiving mechanical chest compression. The occurrence of injuries overall was associated with the duration of chest compression (P = 0.02, OR 1.02). Conclusion: Mechanical chest compression as an adjunct to manual chest compression was strongly associated with potentially life-threatening visceral injuries. The duration of chest compression was associated with injury. Our results suggest that mechanical chest compression should only be applied in situations where manual chest compression is unfeasible.

AB - Objective: Concerns for iatrogenic injuries associated with cardiopulmonary resuscitation led us to investigate the extent and the pattern of chest compression-related injuries in patients subjected to either mechanical and/or manual cardiac compression. Method: In a retrospective study, we performed a manual review of all prehospital discharge reports, in-hospital records, and autopsy reports for evidence of injuries related to chest compression. We included all patients receiving physician-administrated treatment for out-of-hospital cardiac arrest in the Region of Southern Denmark from 2015 to 2017. Results: Eighty four patients undergoing manual and mechanical chest compression and 353 patients with manual chest compression only were included. Unadjusted, mechanical chest compression as an adjunct was associated with a higher risk of injuries than manual chest compression (P < 0.001, odds ratio, OR 3.10). Adjusted for the duration of compression, this difference waned. Visceral injuries were more frequent in patients receiving mechanical chest compression even when adjusted for the duration of compression, age, sex, body mass index and anticoagulant therapy (P < 0.001, OR 29.84). We found a higher incidence of potentially life-threatening injuries in patients receiving mechanical chest compression. The occurrence of injuries overall was associated with the duration of chest compression (P = 0.02, OR 1.02). Conclusion: Mechanical chest compression as an adjunct to manual chest compression was strongly associated with potentially life-threatening visceral injuries. The duration of chest compression was associated with injury. Our results suggest that mechanical chest compression should only be applied in situations where manual chest compression is unfeasible.

KW - manual chest compression

KW - mechanical chest compression

KW - prehospital cardiac arrest

U2 - 10.1111/aas.13347

DO - 10.1111/aas.13347

M3 - Journal article

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VL - 63

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JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

SN - 0001-5172

IS - 6

ER -