Abstract 12854: Parenchymal Lung Injuries Related to Standard Cardiopulmonary Resuscitation
Purpose: Little is known about parenchymal lung injuries after external chest compressions during cardiopulmonary resuscitation (CPR). We analysed chest CT scan to evaluate parenchymal lung injury and its clinical significance in patients who received standard CPR and were resuscitated from cardiac arrest.
Materials and Methods: We enrolled non-traumatic out-of-hospital cardiac arrest patients older than 18 years old who had been admitted to the ED in cardiac arrest and successfully resuscitated after CPR. Chest CT was obtained immediately after return of spontaneous circulation (ROSC). To allocate the area of lung contusion, we divided both hemithoraces into upper, middle, and lower parts longitudinally and each part was subdivided into 4 regions (anteromedial, anterolateral, posteromedial, and posterolateral) except the lower part of the left lung. Finally, both lungs were divided into 23 regions. To stratify the severity of lung contusion, each region was scored depending on the area of lung contusion (ALC) with 1 = ALC<1/3 of a region, 2 = 1/3≤ALC<2/3 of a region and 3=ALC≥2/3 of a region. Oxygenation index (OI: PaO2/FiO2) was measured at the time of ROSC, 24hr, 48hr, 72hr, and 1 week after cardiac arrest. Acute lung injury (ALI) was defined as OI below 300.
Results: Ninety-one patients were enrolled. Lung contusion was developed in 37 patients (40.7%) and median lung contusion score was 15 (0-15). Lung contusion was not associated with hospital mortality (p=0.318), development of ALI (p=0.515), or the length of ICU stay (p=0.203). The OI at the time of ROSC was lower in patients with lung contusion score > 23 than in patients with lung contusion score≤23 (164±93 vs. 278±122, p=0.008). However, the OI at 24hrs, 72hrs, and 1 week after ROSC was not different between patients with lung contusion score > 23 and patients with lung contusion score≤23 (p=0.240, 0.698, 0.446, and 0.168, respectively)
Conclusion: Extensive lung contusion is associated with a lower oxygenation index at the time of ROSC, but did not affect the resuscitation outcome.
Author Disclosures: K. Cha: None. S. Hwang: None. H. Kim: None. O. Kim: None. Y. Cha: None. H. Kim: None. K. Lee: None.
- © 2016 by American Heart Association, Inc.