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European Radiology

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01-10-2018 | Emergency Radiology

Use of whole body CT to detect patterns of CPR-related injuries after sudden cardiac arrest

Authors: Gregor M. Dunham, Alexandre Perez-Girbes, Ferdia Bolster, Kellie Sheehan, Ken F. Linnau

Published in: European Radiology | Issue 10/2018

Abstract

Aims and objectives

We have recently implemented a dedicated sudden cardiac arrest (SCA) - whole-body computed tomography (WBCT) protocol to evaluate SCA patients with return of spontaneous circulation (ROSC) following cardiopulmonary resuscitation (CPR). The aim of this study is to evaluate the number and pattern of CPR-related injuries in ROSC patients with SCA-WBCT.

Methods and materials

Single-centre retrospective review of 39 patients (13 female; 20 male, mean age 51.8 years) with non-traumatic, out-of-hospital SCA and ROSC and evaluation with dedicated SCA-WBCT over a 10-month period.

Results

In-hospital mortality was 54%. CPR-related injuries were detected in 85% (33/39).

Chest injuries were most common on WBCT: 85% (33) subjects had rib fractures (mean of 8.5 fractures/subject); 31% (12) sternal fractures; 13% (5) mediastinal haematoma; 10% (4) pneumothorax; 8% (3) pneumomediastinum and 3% (1) haemothorax. Three subjects (8%) had abdominal injuries on WBCT, including one hepatic haematoma with active haemorrhage.

Conclusion

CPR-related injuries on WBCT after ROSC are common, with serial rib fractures detected most commonly. An unexpectedly high rate of abdominal injuries was detected on SCA-WBCT. Radiologists need to be attuned to the spectrum of CPR-related injuries in WBCT, including abdominal injuries and subtle rib fractures.

Key Points

• CPR frequently causes injuries.

• Radiologists should be aware of the spectrum of CPR related injuries.

• Rib fractures are frequent and radiologic findings often subtle.

• Clinically unexpected abdominal injuries may be present.

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Title: Use of whole body CT to detect patterns of CPR-related injuries after sudden cardiac arrest
Authors: Gregor M. Dunham
Alexandre Perez-Girbes
Ferdia Bolster
Kellie Sheehan
Ken F. Linnau
Publication date: 01-10-2018
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 10/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-017-5117-0

At a glance: The STEP trials

Springer Medicine

Use of whole body CT to detect patterns of CPR-related injuries after sudden cardiac arrest

Abstract

Aims and objectives

Methods and materials

Results

Conclusion

Key Points

At a glance: The STEP trials

Springer Medicine

Abstract

Aims and objectives

Methods and materials

Results

Conclusion

Key Points

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