In movies and television, CPR is a miraculous, dramatic event. Pulses return, patients open their eyes and make a witty remark, and everyone celebrates.
The reality: CPR is a brutal, violent intervention. And, the new mechanical CPR devices are even moreso.
This is a brief autopsy-based survey of 222 patients in whom CPR was unsuccessful, 83 of which were treated with manual CPR only, and 139 patients who received primarily mechanical CPR. Mean age was ~67 years, about 30% female, and mean CPR time was ~35 minutes. That is, to say the least, ample time to crush the thorax.
A brief accounting of the injuries from CPR:
- Multiple rib fractures: 57.3% manual, 65.0% mechanical
- Sternal fractures: 54.2% manual, 58.3% mechanical
- Intrathoracic bleeding: 36.1% manual, 48.9% mechanical
- Cardiac injuries: 7.2% manual, 15.2% mechanical
- Liver injuries: 3.6% manual, 7.9% mechanical
Pathologists at autopsy, however, did not judge any of the injuries from CPR to have contributed to the cause of death.
Injuries in those for whom CPR is unsuccessful are intuitively more severe than for cases in which patients survive – a result of non-survivors being generally older, more brittle, and longer CPR duration. However, it’s an interesting window into the destructive nature of vigorous CPR – and the increased injury associated with mechanical devices.
“CPR-related injuries after manual or mechanical chest compressions with the LUCAS device: A multicentre study of victims after unsuccessful resuscitation”
http://www.ncbi.nlm.nih.gov/pubmed/25277343