No difference in autopsy detected injuries in cardiac arrest patients treated with manual chest compressions compared with mechanical compressions with the LUCAS™ device—A pilot study

Abstract

Aim To compare the variety and incidence of internal injuries after manual and mechanical chest compressions during CPR. Methods In a prospective pilot study conducted in two Swedish cities, 85 patients underwent autopsy after unsuccessful resuscitation attempts with manual or mechanical chest compressions, the latter with the LUCAS™ device. Autopsy was performed and the results were evaluated according to a specified protocol. Results No injuries were found in 26/47 patients in the manual group and in 16/38 patients in the LUCAS group ( p = 0.28). Sternal fracture was present in 10/47 in the manual group and 11/38 in the LUCAS group ( p = 0.46), and there were multiple rib fractures (≥3 fractures) in 13/47 in the manual group and in 17/38 in the LUCAS group ( p = 0.12). Bleeding in the ventral mediastinum was noted in 2/47 and 3/38 in the manual and LUCAS groups respectively ( p = 0.65), retrosternal bleeding in 1/47 and 3/38 ( p = 0.32), epicardial bleeding in 1/47 and 4/38 ( p = 0.17), and haemopericardium in 4/47 and 3/38 ( p = 1.0) respectively. One patient in the LUCAS group had a small rift in the liver and one patient in the manual group had a rift in the spleen. These injuries were not considered to have contributed to the patient's death. Conclusion Mechanical chest compressions with the LUCAS™ device appear to be associated with the same variety and incidence of injuries as manual chest compressions.