Department of General, Visceral and Thoracic Surgery Lehrkrankenhaus Feldkirch, 6800 Feldkirch, Austria.
Department of Medical and Surgical Science, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy.
Rev Cardiovasc Med. 2022 Feb 14;23(2):61. doi: 10.31083/j.rcm2302061.
Current studies focus primarily on skeletal injuries following cardiopulmonary resuscitation (CPR). Few studies report on intrathoracic injuries (ITI) and none, to our knowledge, focus exclusively on cardiovascular injuries related to cardiac massage. This study was based on autopsy findings and assessed the incidence of non-skeletal CPR related injuries related to chest compression.
This was a retrospective forensic autopsy cohort study conducted in a single institution after resuscitation. Pathologists recorded autopsy data using standardized protocol contained information from external and internal examination of the body.
Thirty-eight autopsy reports (21 males and 17 females), post- CPR-failure were studied. Heart lesions were reported in 19 patients (group A). The average age was 65.7 years (69.05 group A and 66.5 group B). Median weight was 75.2 Kg and was significantly higher in group B ( = 0.01). Pericardial lesions were identified in 6 patients in group A and 2 in group B ( = 0.2 ns). No significant difference was observed among the two groups (Table 4) with the exception of the average number of rib fractures which was higher in group A ( = 0.04). Autopsy findings revealed heart injuries in 50% of patients with a high prevalence (52.6%) of left ventricle injuries.
Cardiac lesions represent frequent and serious complications of unsuccessful CPR. Correct performance of chest compressions according to guidelines is the best way to avoid these complications.
目前的研究主要集中在心肺复苏（CPR）后骨骼损伤上。很少有研究报告胸内损伤（ITI），据我们所知，也没有专门研究与心脏按摩相关的心血管损伤。本研究基于尸检结果，评估了与胸部按压相关的非骨骼 CPR 相关损伤的发生率。
这是一项在复苏后在一家机构进行的回顾性法医尸检队列研究。病理学家使用包含尸体外部和内部检查信息的标准化方案记录尸检数据。
研究了 38 份心肺复苏失败后的尸检报告（21 名男性和 17 名女性）。19 名患者（A 组）报告有心脏损伤。平均年龄为 65.7 岁（A 组为 69.05 岁，B 组为 66.5 岁）。中位数体重为 75.2kg，B 组显著更高（ = 0.01）。A 组有 6 名患者和 B 组有 2 名患者存在心包损伤（ = 0.2 无统计学意义）。除了 A 组的平均肋骨骨折数更高（ = 0.04）外，两组之间没有观察到显著差异（表 4）。尸检结果显示，50%的患者存在心脏损伤，其中左心室损伤的患病率较高（52.6%）。
心脏损伤是心肺复苏不成功的常见且严重的并发症。根据指南正确进行胸部按压是避免这些并发症的最佳方法。
