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

  • Emergency Radiology
  • Published:
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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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Acknowledgements

Scientific paper was presented at ECR 2017 (17-P-1685-ECR).

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Authors and Affiliations

  1. Department of Radiology, University of Washington, 1959 N.E. Pacific Street, Seattle, WA, 98195-7117, USA

    Gregor M. Dunham, Kellie Sheehan & Ken F. Linnau

  2. University and Polytechnic Hospital La Fe, Valencia, Spain

    Alexandre Perez-Girbes

  3. Mater Misericordiae Hospital, Dublin, Ireland

    Ferdia Bolster

Authors
  1. Gregor M. Dunham
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  2. Alexandre Perez-Girbes
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  3. Ferdia Bolster
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  4. Kellie Sheehan
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  5. Ken F. Linnau
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Corresponding author

Correspondence to Gregor M. Dunham.

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Guarantor

The scientific guarantor of this publication is Ken F. Linnau, MD, MS.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Funding

This study was partially supported by the Institute of Translational Health Science (ITHS) (grant UL1 RR025014 from NCRR/NIH).

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• observational

• performed at one institution.

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Dunham, G.M., Perez-Girbes, A., Bolster, F. et al. Use of whole body CT to detect patterns of CPR-related injuries after sudden cardiac arrest. Eur Radiol 28, 4122–4127 (2018). https://doi.org/10.1007/s00330-017-5117-0

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  • DOI: https://doi.org/10.1007/s00330-017-5117-0

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