Michele Paterno (Lecco / IT), Samantha Bozzo (Lecco / IT), Marco Chiarelli (Lecco / IT), Elisa Bolzoni (Lecco / IT), Alessia Malagnino (Lecco / IT), Ariberto Brivio (Lecco / IT), Fulvio Tagliabue (Lecco / IT), Mauro Zago (Lecco / IT)
Abstract text (incl. references and figure legends)
H: A three-case series of CPR complications has been reported at our Institution in 2022. A 47-yo male with cognitive impairment was struck by cardiac arrest during CT-scanning showing suspected hiatal hernia perforation without abdominal findings. A 49-yo female with no medical history was transferred to our hospital after ROSC in pulmonary embolism-induced cardiac arrest treated with manual CPR and thrombolytic therapy. A 51-yo male with unknown history suffered from acute myocardial infarction causing cardiac arrest while driving to the hospital. Initially, out-of-hospital CPR was performed manually, then with LUCAS® device, achieving ROSC.
F: Hypotension, acidosis and acute anemia were observed after ROSC.
I: For the 1st case CT-scan was not meaningful and surgery was needed to reveal the noxa. The other two cases benefitted from Point Of Care US for detecting hemoperitoneum.
D: All three cases consisted of hemoperitoneum due to left liver lacerations following CPR.
T: In the 1st case, after ROSC through manual CPR, emergency laparotomy disclosed S2-3-4 lesions and oozing bleeding without gastric lesions. Abdominal packing was performed. Patient survived. Following FAST and CT scan, 2nd patient underwent emergency laparotomy confirming S3 laceration, S2-3 resection and hepatic packing. Patient survived. Despite angioplasty with stenting, 3rd patient was still hemodynamically unstable. FAST findings justified emergency laparotomy, left hepatic lobectomy and hepatic packing because of S3 injury. Patient died.
C: CPR complications could require emergency surgery. CPR technique and anatomical factors could entail liver injuries. FAST exam after CPR should be included in the algorithms to investigate hemodynamic instability after ROSC. Principles of trauma laparotomy/liver trauma management should be in all general surgeons' background, since patients undergone CPR can be addressed to hospitals without specific trauma expertise.
R: DOI 10.1007/s00134-008-1255-9
Disclosure: Do you have a significant financial interest, consultancy or other relationship with products, manufacturer(s) of products or providers of services related to this abstract? (If not, please enter "No" in the text field.)
No