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Intensive Care Medicine

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01.03.2009 | Review

Frequent and rare complications of resuscitation attempts

verfasst von: Claas T. Buschmann, Michael Tsokos

Erschienen in: Intensive Care Medicine | Ausgabe 3/2009

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Abstract

Introduction

Resuscitation attempts require invasive iatrogenic manipulations on the patient. On the one hand, these measures are essential for survival, but on the other hand can damage the patient and thus contain a significant violation risk of both medical and forensic relevance for the patient and the physician. We differentiate between frequent and rare resuscitation-related injuries. Factors of influence are duration and intensity of the resuscitation attempts, sex and age of the patient as well as an anticoagulant medication.

Materials and methods

Review of current literature and report on autopsy cases from our institute (approximately 1,000 autopsies per year).

Results

Frequent findings are lesions of tracheal structures and bony chest fractures. Rare injuries are lesions of pleura, pericardium, myocardium and other internal organs as well as vessels, intubation-related damages of neural and cartilaginous structures in the larynx and perforations of abdominal organs such as liver, stomach and spleen.

Conclusion

We differentiate between frequent and rare complications. The risk of iatrogenic CPR-related trauma is even present with adequate execution of CPR measures and should not question the employment of proven medical techniques.

Alconero Camarero AR, Casaus Pérez M, Gutiérrez Caloca N (2006) Incidents of cutaneous alteration secondary to external electrical cardioversion. Enferm Intensiva 17:163–172PubMedCrossRef

Bauer H, Welsch K (1976) Punktions-Techniken in der Notfallmedizin. Münchener Medizinische Wochenschrift 118:567–572PubMed

Betz P, Liebhardt E (1994) Rib fractures in children—resuscitation or child abuse? Int J Legal Med 106:215–218PubMedCrossRef

Bode G, Joachim H (1987) Zur Differentialdiagnose von Unfall- und Reanimationstraumen. Z Rechtsmed 98:19–32PubMedCrossRef

Darok M (2004) Injuries resulting from resuscitation procedures. In: Tsokos M (ed) Forensic pathology reviews Vol 1. Humana Press Inc, Totowa NJ, pp 293–303

Eldor J, Ofek B, Abramowitz HB (1990) Perforation of oesophagus by tracheal tube during resuscitation. Anaesthesia 45:70–71PubMedCrossRef

Hartoko TJ, Demey HE, Rogers PE, Decoster HL, Nagler JM, Bossaert LL (1991) Pneumoperitoneum—a rare complication of cardiopulmonary resuscitation. Acta Anaesth Scand 35:235–237PubMedCrossRef

Hashimoto Y, Moriya F, Furumiya J (2007) Forensic aspects of complications resulting from cardiopulmonary resuscitation. Leg Med 9:94–99CrossRef

Hoke RS, Chamberlain D (2004) Skeletal chest injuries secondary to cardiopulmonary resuscitation. Resuscitation 63:327–338PubMedCrossRef

10.

Jaeger K, Ruschulte H, Osthaus A, Scheinichen S, Heine J (2000) Tracheal injury as a sequence of multiple attempts of endotracheal intubation in the course of a preclinical cardiopulmonary resuscitation. Resuscitation 43:147–150PubMedCrossRef

11.

Kardiopulmonale Reanimation—Aktuelle Leitlinien des European Resuscitation Council (2006) Notfall- und Rettungsmedizin 9:4–170

12.

Klintschar M, Darok M, Radner H (1998) Massive injury to the heart after attempted active compression–decompression cardiopulmonary resuscitation. Int J Legal Med 111:93–96PubMedCrossRef

13.

Kurkciyan I, Meron G, Sterz F, Müllner M, Tobler K, Domanovits H, Schreiber W, Bankl HC, Laggner AN (2003) Major bleeding complications after cardiopulmonary resuscitation: impact of thrombolytic treatment. J Int Med 253:128–135CrossRef

14.

Krause S, Donen N (1984) Gastric rupture during cardiopulmonary resuscitation. Can Anaesth Soc J 31:319–322PubMedCrossRef

15.

Krischer JP, Fine EG, Davis JH, Nagel EL (1987) Complications of cardiac resuscitation. Chest 92:287–291PubMedCrossRef

16.

Larsen R (2002) Kardiopulmonale Reanimation. In: Larsen R (ed) Anästhesie, 8th edn. Urban and Fischer Publishing House, München Jena, pp 851–900

17.

Lawes EG, Baskett PJ (1987) Pulmonary aspiration during unsuccessful cardiopulmonary resuscitation. Intensive Care Med 13:379–382PubMedCrossRef

18.

Lederer W, Mair D, Rabl W, Baubin M (2004) Frequency of rib and sternum fractures associated with out-of-hospital cardiopulmonary resuscitation is underestimated by conventional chest X-ray. Resuscitation 60:157–162PubMedCrossRef

19.

Maxeiner H (1988) Weichteilverletzungen am Kehlkopf bei notfallmäßiger Intubation. Anästh Intensivmed 29:42–49

20.

Meron G, Kurkciyan I, Sterz F, Susani M, Domanovits H, Tobler K, Bohdjalian A, Laggner AN (2007) Cardiopulmonary resuscitation-associated major liver injury. Resuscitation. doi:10.1016/j.resuscitation.2007.05.023

21.

Mills SA, Paulson D, Scott SM, Sethi G (1983) Tension pneumoperitoneum and gastric rupture following cardiopulmonary resuscitation. Ann Emerg Med 12:94–95PubMedCrossRef

22.

Minor RL Jr, Chandran PK, Williams CL (1990) Rhabdomyolysis and myoglobinuric renal failure following cardioversion and CPR for acute MI. Chest 97:485–486PubMedCrossRef

23.

Noffsinger AE, Blisard KS, Balko MG (1991) Cardiac laceration and pericardial tamponade due to cardiopulmonary resuscitation after myocardial infarction. J Forensic Sci 36:1760–1764PubMed

24.

Odom A, Christ E, Kerr N, Byrd K, Cochran J, Barr F, Bugnitz M, Ring JC, Storgion S, Walling R, Stidham G, Quasney MW (1997) Prevalence of retinal hemorrhages in pediatric patients after in-hospital cardiopulmonary resuscitation: a prospective study. Pediatrics. doi:10.1542/peds.99.6.e3

25.

Price EA, Rush LR, Perper JA, Bell MD (2000) Cardiopulmonary resuscitation-related injuries and homicidal blunt abdominal trauma in children. Am J Forensic Med Pathol 21:307–310PubMedCrossRef

26.

Rabl W, Baubin M, Haid C, Pfeiffer KP R, Scheithauer R (1997) Review of active compression–decompression cardiopulmonary resuscitation (ACD-CPR). Analysis of iatrogenic complications and their biomechanical explanation. Forensic Sci Int 89:175–183PubMedCrossRef

27.

Reichardt JA, Casey GD, Krywko D (2008) Gastric rupture from cardiopulmonary resuscitation or seizure activity? a case report. J Emerg Med. doi:10.1016/j.jemermed.2007.10.041

28.

Ryan MP, Young SJ, Wells DL (2003) Do resuscitation attempts in children who die, cause injury? Emerg Med J 20:10–12PubMedCrossRef

29.

Saternus KS, Fuchs V (1982) Verletzungen der A. carotis communis durch Reanimationsmaßnahmen. Z Rechtsmed 88:305–311

30.

Schvadron E, Moses Y, Weissberg D (1996) Gastric rupture complicating inadvertent intubation of the esophagus. Can J Surg 39:487–489PubMed

31.

Shulman D, Beilin B, Olshwang D (1987) Pulmonary barotrauma during cardiopulmonary resuscitation. Resuscitation 15:201–207PubMedCrossRef

32.

Sokolove PE, Willis-Shore J, Panacek EA (2002) Exsanguination due to right ventricular rupture during closed-chest cardiopulmonary resuscitation. J Emerg Med 23:161–164PubMedCrossRef

33.

Sperry K (1990) Anterior thoracic wall trauma in elderly homicide victims. The “CPR” defense. Am J Forensic Med Pathol 11:50–55PubMedCrossRef

34.

Strear CM, Jarnagin WR, Schecter W, Mackersie RC, Hickey MS (1998) Gastric rupture and tension pneumoperitoneum complicating cardiopulmonary resuscitation: case report. J Trauma 44:930–932PubMedCrossRef

35.

Umach P, Unterdorfer H (1980) Organverletzungen durch Reanimationsmaßnahmen. Beiträge zur Gerichtlichen Medizin 38:29–32PubMed

36.

Valenzuela TD, Kern KB, Clark LL, Berg RA, Berg MD, Berg DD, Hilwig RW, Otto CW, Newburn D, Ewy GA (2005) Interruptions of chest compressions during emergency medical systems resuscitation. Circulation 112:1259–1265PubMedCrossRef

37.

van der Voort DJ, Geusens PP, Dinant GJ (2001) Risk factors for osteoporosis related to their outcome: fractures. Osteoporos Int 12:630–638PubMedCrossRef

38.

Wik L, Kramer-Johansen J, Myklebust H, Sørebø H, Svensson L, Fellows B, Steen PA (2005) Quality of cardiopulmonary resuscitation during out-of-hospital cardiac arrest. JAMA 293:299–304PubMedCrossRef

39.

Yamaki T, Ando S, Ohta K, Kubota T, Kawasaki K, Hirama M (1989) CT demonstration of massive cerebral air embolism from pulmonary barotraumas due to cardiopulmonary resuscitation. J Comput Assist Tomogr 13:313–315PubMedCrossRef

40.

Ziegenfuss MD, Mullany DV (2004) Traumatic liver injury complicating cardio-pulmonary resuscitation. The value of a major intensive care facility: a report of two cases. Crit Care Resusc 2:102–104

Titel: Frequent and rare complications of resuscitation attempts
verfasst von: Claas T. Buschmann
Michael Tsokos
Publikationsdatum: 01.03.2009
Verlag: Springer-Verlag
Erschienen in: Intensive Care Medicine / Ausgabe 3/2009
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-008-1255-9

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Frequent and rare complications of resuscitation attempts

Abstract

Introduction

Materials and methods

Results

Conclusion

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Abstract

Introduction

Materials and methods

Results

Conclusion

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