Abstract 32: Mechanical Chest Compressions With The LUCAS Device Does Not Increase The Incidence Of Injuries In Cardiac Arrest Victims
Introduction: The eventual harm done by mechanical chest compressions using the LUCAS device during cardiopulmonary resuscitation (CPR) is under debate. However, a prospective study comparing injuries after mechanical or manual chest compressions has not been performed.
Hypothesis: We hypothesized that there is no difference in the incidence of injuries after manual versus mechanical chest compressions using the LUCAS device.
Methods: In a prospective study, from February 1, 2005, to April 1, 2007, patient’s not surviving cardiac arrest in two Swedish cities underwent autopsy based upon decision by the admitting physician. The pathologist recorded data from the autopsy in a standardized study protocol regarding external and internal injuries. During CPR, the patients had been treated with either manual or mechanical chest compressions with the LUCAS device.
Results: Eighty-five patients underwent autopsy out off which 47 patients had received manual chest compressions and 38 patients mechanical chest compressions. No injuries (skin wounds and skin marks not included) were found in 23/47 patients in the manual group versus 18/38 patients in the LUCAS group (p = 1.0). Sternum fracture and multiple costal fractures (≥3 fractures) were present in 10/47 versus 11/38 (p=0.46) and in 13/47 versus 16/38 (p=0.18) in the manual and LUCAS group respectively. Bleeding in the ventral mediastinum, 2/47 versus 3/38 (p=0.65), retrosternal bleeding, 1/47 versus 3/38 (p=0.32), epicardial, 1/47 versus 4/38 (p=0.17) and hemopericardial bleeding, 4/47 versus 3/38 (p=1.0) was found in the manual and LUCAS group respectively. There was one ruptured abdominal aortic aneurysm in the LUCAS group and one thoracic aortic dissection in each group, all considered by the pathologist as primary cause of the cardiac arrest and not secondary injuries from either treatment. One patient in the LUCAS group had a 4 cm rift in the liver with no bleeding and one patient in the manual group had a rift in the spleen with bleeding. Neither of these injuries was considered to be the cause of death.
Conclusion: Mechanical chest compressions with the LUCAS device seem to have the same pattern of injuries as manual compressions and do not increase the incidence of injuries after CPR.