Out-of-Hospital Cardiac Arrest With Bilateral Urinary Tract Injury Resulting From Cardiopulmonary Resuscitation: A Case Report

TL;DR

A man who had a cardiac arrest developed urinary tract injuries likely caused by chest compressions during resuscitation.

Contribution

This case report highlights urinary tract injury as a rare complication of cardiopulmonary resuscitation.

Findings

Computed tomography showed contrast leakage into the bilateral renal pelvis and bladder retention.

Urinalysis revealed gross hematuria without evidence of pre-existing urinary tract disease.

Urinary tract injury was attributed to chest compressions during resuscitation.

Abstract

A man in his 70s suffered cardiac arrest, and his family initiated cardiopulmonary resuscitation after placing an emergency call. The initial waveform of the automated external defibrillator performed by emergency medical technicians revealed ventricular fibrillation. The patient received cardiovascular life support, including direct current countershock, and was transported to the hospital. Upon arrival, he underwent extracorporeal cardiopulmonary resuscitation using an automated chest compression device. Additionally, an intra-aortic balloon pumping was introduced after coronary angiography and percutaneous coronary intervention. Plain computed tomography images revealed leakage of the contrast medium used during coronary angiography in the bilateral renal pelvis and perirenal area as well as bladder retention. Furthermore, a urine test revealed gross hematuria. There were no findings of prostatic hypertrophy or urinary tract disease. Based on the patient's clinical course, injury caused by chest compression was the most likely etiology of urinary tract injury, which must be considered in such patients. The patient was discharged with cerebral performance category 1, without any complication except urinary tract.

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