Buschmann Claas T, Tsokos Michael
University Medical Centre Charité, University of Berlin, Institute of Legal Medicine and Forensic Sciences, Berlin, Germany.
Intensive Care Med. 2009 Mar;35(3):397-404. doi: 10.1007/s00134-008-1255-9. Epub 2008 Sep 20.
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.
Review of current literature and report on autopsy cases from our institute (approximately 1,000 autopsies per year).
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.
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.
复苏尝试需要对患者进行侵入性医源性操作。一方面，这些措施对生存至关重要，但另一方面可能会对患者造成损害，因此对患者和医生而言都存在医疗和法医方面重大的违规风险。我们区分常见和罕见的与复苏相关的损伤。影响因素包括复苏尝试的持续时间和强度、患者的性别和年龄以及抗凝药物治疗情况。
回顾当前文献并报告我们研究所的尸检病例（每年约1000例尸检）。
常见发现为气管结构损伤和肋骨骨折。罕见损伤包括胸膜、心包、心肌及其他内脏器官以及血管的损伤、喉内神经和软骨结构的插管相关损伤以及肝脏、胃和脾脏等腹部器官的穿孔。
我们区分常见和罕见并发症。即使正确实施心肺复苏措施，也存在与医源性心肺复苏相关的创伤风险，且不应质疑已证实的医疗技术的应用。
