Cieľom tejto prospektívnej autoptickej štúdie bolo vyhodnotiť množstvo a závažnosť poranení vznikajúcich v súvislosti s kardiopulmonálnou resuscitáciou (KPR) na kohorte osôb zomrelých na území Moravsko-sliezskeho kraja. V sledovanom období bolo do štúdie celkovo zaradených 80 osôb, u ktorých bola pred smrťou vykonávaná KPR kvôli zástave srdca, ktorá nebola spôsobená mechanickou traumou. KPR asociované poranenia boli identifikované u 75 (93,7 %) osôb, pričom u 73 osôb sa jednalo o viacnásobné poranenia. V niektorých prípadoch sa jednalo až o život ohrozujúce poranenia (za predpokladu, že by u týchto osôb došlo k obnoveniu obehu).

The aim of the present study is to investigate incidence and seriousness of CPR-associated injuries on a cohort of CPR non-survivors after out-of-hospital cardiac arrest in the Moravian-Silesian region. In total, 80 persons were included in the study within the study period (2012 – 2015). CPR-associated injuries were identified in 75 (93.7 %) persons, multiple injuries were found in 73 persons. Spectrum of identified injuries covered skin injuries of the upper half of the body, head and neck injuries, rare abdominal injuries and very frequent thorax injuries. Sternal fractures were found in 53 (63.3 %) persons. Rib fractures were identified in 59 (73.0 %) persons; rib fractures were usually multiple (mean number of broken ribs was 7.6 per person). Intra-thoracic injuries were diagnosed in 33 (41.2 %) persons – findings of lung contusions and lacerations, transmural heart contusions, hemothorax and hemopericard. The vast majority of identified intra-thoracic injuries were considered clinically relevant (provided the fact that return of spontaneous circulation had been achieved). Intraabdominal injuries (liver and spleen injuries) were identified in 15 (18.7 %) of persons. Vast majority of these injuries was clinically irrelevant. We have found clinically serious injuries (spleen rupture and liver dilacerations) in 3 (3.7 %) persons. Outcomes of our study suggest that CPR-associated injuries are very common, usually multiple, and in some cases they might be even potentially lethal (if return of spontaneous circulation is achieved).

Katedra chirurgických oborů Lékařská fakulta Ostravské University

Katedra intenzivní medicíny a forenzních oborů Lékařská fakulta Ostravské University

Ústav soudního lékařství FN Ostrava

Ústav soudního lékařství LF UK a FN Hradec Králové

Injuries associated with cardiopulmonary resuscitation in non-survivors after out-of-hospital cardiac arrest (autopsy study)