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Chest injuries after active compression–decompression cardiopulmonary resuscitation (ACD-CPR) in cadavers

  • M Baubin
    Correspondence
    Corresponding author. Tel.: +43-512-5048523; fax: +43-512-5042450
    Affiliations
    Department of Anesthesia and Intensive Care Medicine, The Leopold-Franzens-University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria

    Institute for Emergency Medicine, The Leopold-Franzens-University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria
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  • W Rabl
    Affiliations
    Institute of Forensic Medicine, The Leopold-Franzens-University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria
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  • K.P Pfeiffer
    Affiliations
    Institute for Biostatistics, The Leopold-Franzens-University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria
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  • A Benzer
    Affiliations
    Department of Anesthesia and Intensive Care Medicine, The Leopold-Franzens-University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria
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  • H Gilly
    Affiliations
    Ludwig Boltzmann Institute of Experimental Anesthesiology and Research in Intensive Care, Vienna, Austria
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      Abstract

      In a prospective study of 38 cadavers of patients older than 18 without previous chest injury or cardiopulmonary resuscitation (CPR), active compression–decompression (ACD) resuscitation manoeuvres were performed to determine possible factors influencing sternal and/or rib fractures. ACD was performed for 60 s, with compression and decompression forces being continuously recorded. A stepwise logistic regression analysis was applied. Factors analyzed were age, gender, use of a compression cushion beneath the piston of the ACD device (Ambu CardioPump®), and maximal compression and decompression forces. After ACD, the cadavers were autopsied and thoracic injuries were assessed. There was a significant correlation between sternal fractures and gender (P=0.008), and between rib fractures and age (P=0.008). Women were found to have a higher risk for sternal fractures, whereas older patients had a higher risk for rib fractures. Maximal compression force was another factor in sternal and/or rib fracture (P=0.048). Even though a significantly higher incidence of sternal fractures was observed when the compression cushion was used (P=0.045), inclusion of this variable in the regression analysis only marginally improved the prediction for correct classification of sternal fractures. In conclusion, when well controlled ACD-CPR is performed in cadavers, age is the most important factor determining the incidence of rib fracture. Sternal fractures were more common in female cadavers.

      Keywords

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