EVALUATION OF COMPLICATIONS ASSOCIATED WITH CARDIOPULMONARY RESUSCITATION IN EMERGENCY DEPARTMENT

Abstract

Introduction: Resuscitation methods are commonly used to restore return of spontaneous circulation (ROSC) in patients
with arrest. However, during these resuscitation practices, complications are inevitable.
Aim: The aim of this study was to compare complications due to cardiopulmonary resuscitation (CPR) performed in an
adult emergency department (ED) as well as the diagnostic tools used to evaluate these complications.
Methods: This prospective study was conducted in the ED of Ankara Training and Research Hospital between
01.06.2012 and 30.05.2013. Participants consisted of all patients over the age of 18 with non-traumatic cardiac arrest who
were brought to the hospital by ambulance, relatives, friends, or acquaintances. Those who arrested and received CPR
during ED follow-up were also included.
Results: A total of 136 patients, comprised of 59 women (43.4%) and 77 men (56.6%), who presented with
cardiopulmonary arrest were included in the study. Return of spontaneous circulation was observed in 62 patients (45.6%),
while 74 patients (54.4%) were declared exitus following CPR. Rib fractures were detected in 36.7%, of patients, sternum
fractures in 33.8%, pneumothorax in 2.9%, and liver injury in 0.7% of the patients. Although only 30.9% of rib fractures were
diagnosed by chest X-ray, chest X-ray was found to be superior to ultrasonography (US) in the detection of rib fractures (p <
0.005). The diagnosis of rib fractures was achieved with combined chest X-ray and US in 19.8%.
Conclusion: The most common complications of CPR were found to be rib and sternal fractures. The results further
suggest that evaluation of CPR-related complications using chest X-ray and US in combination can efficiency higher
diagnostic accuracy.