Citation

Champigneulle B, Haruel PA, Pirracchio R, Dumas F, Geri G, Arnaout M, Paul M, Pène F, Mira JP, Bougouin W, Cariou A. Resuscitation 2018; 128: 70-75.

Affiliation

Medical ICU, Cochin Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France; Université Paris-Descartes-Sorbonne-Paris-Cité, Paris, France; INSERM U970 Sudden Death Expertise Center, Paris Cardiovascular Research Center, Paris, France.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.resuscitation.2018.04.022

PMID

29698751

Abstract

AIM: Due to collapse and cardiopulmonary resuscitation (CPR) maneuvers, major traumatic injuries may complicate the course of resuscitation for out-of-hospital cardiac arrest patients (OHCA). Our goals were to assess the prevalence of these injuries, to describe their characteristics and to identify predictive factors.

METHODS: We conducted an observational study over a 9-year period (2007-2015) in a French cardiac arrest (CA) center. All non-traumatic OHCA patients admitted alive in the ICU were studied. Major injuries identified were ranked using a functional two-level scale of severity (life-threatening or consequential) and were classified as CPR-related injuries or collapse-related injuries, depending of the predominant mechanism. Factors associated with occurrence of a CPR-related injury and ICU survival were identified using multivariable logistic regression.

RESULTS: A major traumatic injury following OHCA was observed in 91/1310 patients (6.9%, 95%CI: 5.6, 8.3%), and was classified as a life-threatening injury in 36% of cases. The traumatic injury was considered as contributing to the death in 19 (21%) cases. Injuries were related to CPR maneuvers in 65 patients (5.0%, (95%CI: 3.8, 6.1%)). In multivariable analysis, age [OR 1.02; 95%CI (1.00, 1.04); p = 0.01], male gender [OR 0.53; 95%CI (0.31, 0.91); p = 0.02] and CA occurring at home [OR 0.54; 95%CI (0.31, 0.92); p = 0.02] were significantly associated with the occurrence of a CPR-related injury. CPR-related injuries were not associated with the ICU survival [OR 0.69; 95%CI (0.36, 1.33); p = 0.27].

CONCLUSIONS: Major traumatic injuries are common after cardiopulmonary resuscitation. Further studies are necessary to evaluate the interest of a systematic traumatic check-up in resuscitated OHCA patients in order to detect these injuries.

Copyright © 2018. Published by Elsevier B.V.

Language: en

Keywords

Injury; cardiac arrest; cardiopulmonary resuscitation; trauma