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J Korean Soc Emerg Med > Volume 31(5); 2020 > Article
Journal of The Korean Society of Emergency Medicine 2020;31(5): 431-439.
심정지 후 시행한 전산화단층촬영에서 확인된 심폐소생술 합병증 연구
오준협 , 김형일
단국대학교 의과대학 응급의학교실
Analysis of the cardiopulmonary resuscitation-related complications based on computed tomography
Jun Hyeop Oh , Hyung Il Kim
Department of Emergency Medicine, College of Medicine, Dankook University Hospital, Cheonan, Korea
Correspondence  Hyung Il Kim ,Tel: 041-550-6840, Fax: 041-556-0524, Email: hilovesjj@naver.com,
Received: March 5, 2020; Revised: April 19, 2020   Accepted: April 29, 2020.  Published online: October 30, 2020.
High-quality cardiopulmonary resuscitation (CPR) needs to be provided to cardiac arrest victims. The chest compression at a 5-6 cm depth and 100-120 beats per minute are recommended according to the 2015 CPR guidelines. The physical forces to the patient’s chest wall cause inevitable complications. This study analyzed the CPR-related complications based on computed tomography (CT).
This was a retrospective, single-center study. The study period was from 2009 to 2019. The cardiac arrest victims received the CPR in or out-of-hospital. After the return of spontaneous circulation, CTs were performed on some survivors. The complications detected on CTs were reviewed, and the types and frequencies of complications, age, sex, arrest location, CPR duration, the survival discharge were investigated.
Among 1,357 cardiac arrest patients during the study period, 368 patients were enrolled. The average age was 64.2, and 66.3% were male. The average CPR duration was 24.6 minutes. The most frequent complication was rib fracture (73.6%). Lung contusion (41.3%), hemothorax (22.0%), sternal fracture (19.3%), and retrosternal hemorrhage (13.6%) were also detected. Those with rib fractures, sternal fractures, and retrosternal hemorrhage were older (P<0.001). Those with rib fractures, lung contusion, hemothorax received longer CPR (P=0.032, P=0.003, and P=0.041). Low survival discharge rates were observed in patients with rib fractures, sternal fractures, and pneumothorax (P=0.002, P=0.014, and P=0.016).
The rib fracture, sternal fracture, and retrosternal hemorrhage were frequent in older patients. Those with rib fractures, lung contusion, or hemothorax received the longer CPR. The survival discharge rates were low in the rib fracture, sternal fracture, pneumothorax patients.
Key words: Cardiopulmonary resuscitation; Heart arrest; Basic cardiac life support; Complication
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