# Thoracic injuries related to mechanical and manual cardiopulmonary resuscitation in the emergency department: a retrospective cohort study

## TL;DR

This study compares thoracic injuries from mechanical and manual CPR in emergency settings, finding different injury patterns between the two methods.

## Contribution

The study identifies distinct injury patterns associated with mechanical versus manual CPR, offering insights for post-mortem evaluations.

## Key findings

- Lung contusions were significantly more common in mechanical CPR compared to manual CPR.
- Manual CPR was associated with a higher frequency of rib fractures compared to mechanical CPR.

## Abstract

The aim of this study was to compare thoracic injuries associated with mechanical and manual cardiopulmonary resuscitation (CPR) methods.

This single-center, retrospective observational cohort study included adult patients who underwent CPR and had post-resuscitation thoracic imaging and/or autopsy findings available. Demographic data (age, gender), type of CPR (mechanical or manual), duration of resuscitation, and thoracic injury patterns were extracted from hospital records. The recorded injuries included rib fractures, sternum fractures, clavicle fractures, scapula fractures, pulmonary contusions, pneumothorax, hemothorax, cardiac tamponade, myocardial hematoma or rupture, vertebral fractures, and mortality.

A total of 50 patients underwent mechanical CPR and 66 patients underwent manual CPR. CPR duration was similar between the mechanical and manual CPR groups (40.18 ± 4.83 vs. 41.10 ± 5.22 min; p = 0.330). Lung contusion was observed in 28% of the mechanical CPR group and in 9.1% of the manual CPR group, showing a statistically significant difference (p = 0.008). Rib fractures were more frequent with manual CPR (4.85 ± 1.64) compared with mechanical CPR (3.96 ± 2.29), with a statistically significant difference (p = 0.023). No statistically significant differences were found between the groups regarding sternum fractures, pneumothorax, hemothorax, pericardial effusion, or thoracic aortic hematoma.

While rib fractures were more frequently seen in manual CPR, lung contusions were more commonly associated with mechanical CPR. These differences in injury patterns may have implications in determining the type of CPR administered during post-mortem examinations.