Complications of Cardiac Resuscitation.

Krischer JP, Fine EG, Davis JH, Nagel EL Chest 1987 Vol 92 Pages 287-291

This prospective study identified 2,187 consecutive prehospital cardiac arrest patients in Dade County, Florida between Jan 1, 1977 and August 31, 1979. 705, or 32.2% were autopsied by the Office of the Medical Examiner to identify the cause of death and the pathologic findings attributable to cardiac resuscitation. These victims were predominantly male (70.7%) with a mean age of 45.6 years. Thoracic complications were observed in 42.7% of the cases. A total of 31.6% had rib fractures, 21.1% had sternal fractures, and 18.3% were reported as having anterior mediastinal hemorrhage. 20.4% of the cases had an upper airway complication (tracheal or oropharynx vomitus in 19.5% as well as tracheal and laryngeal injury [2.6%]). Abdominal visceral complications were noted in 30.8% of the cases (most frequently gastric dilation [29.1%]), and pulmonary complications occurred in 13% of the resuscitation population. Life-threatening complications, such as heart and great vessel injuries, occurred in less than .5% of the cases. Since the alternative is presumably death, the resolution is not to withhold resuscitative efforts, but rather to perform CPR as correctly as possible to prevent avoidable complications.