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. 2023 Jul 14:15:100429.
doi: 10.1016/j.resplu.2023.100429. eCollection 2023 Sep.

Left rib fractures during cardiopulmonary resuscitation are associated with hemodynamic variations in a pig model of cardiac arrest

Deborah Jaeger  1   2 , Rajat Kalra  1 , Pierre Sebastian  1 , Christopher Gaisendrees  1   3 , Marinos Kosmopoulos  1 , Guillaume Debaty  1   4 , Tahar Chouihed  2 , Jason Bartos  1 , Demetris Yannopoulos  1
Affiliations

Left rib fractures during cardiopulmonary resuscitation are associated with hemodynamic variations in a pig model of cardiac arrest

Deborah Jaeger et al. Resusc Plus. .

Abstract

Background: Chest compressions (CC) are the cornerstone of cardiopulmonary resuscitation (CPR). But CC are also known to cause injuries, specifically rib fractures. The effects of such fractures have not been examined yet. This study aimed to investigate hemodynamic effects of rib fractures during mechanical CPR in a porcine model of cardiac arrest (CA).

Methods: We conducted a retrospective hemodynamic study in 31 pigs that underwent mechanical CC. Animals were divided into three groups based on the location of rib fractures: No Broken Ribs group (n = 11), Left Broken Ribs group (n = 13), and Right Broken Ribs group (n = 7). Hemodynamic measurements were taken at 10 seconds before and 10, 30, and 60 seconds after rib fractures.

Results: Baseline hemodynamic parameters did not differ between the three groups. Systolic aortic pressure was overall higher in the Left Broken Ribs group than in the No Broken Ribs group at 10, 30, and 60 seconds after rib fracture (p = 0.02, 0.01, and 0.006, respectively). The Left Broken Ribs group had a significantly higher right atrial pressure compared to the No Broken Rib group after rib fracture (p = 0.02, 0.01, and 0.03, respectively). There was no significant difference for any parameter for the Right Broken Ribs group, when compared to the No Broken Ribs group.

Conclusion: An increase in main hemodynamic parameters was observed after left rib fractures while right broken ribs were not associated with any change in hemodynamic parameters. Reporting fractures and their location seems worthwhile for future experimental studies.

Keywords: Cardiac arrest; Chest compressions; Resuscitation; Rib fractures.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Comparison of systolic aortic pressure (mmHg) in each group at four timepoints.
Fig. 2
Fig. 2
Comparison of mean aortic pressure (mmHg) in each group at four timepoints.
Fig. 3
Fig. 3
Comparison of right atrial mean pressure (mmHg) in each group at four timepoints.
Fig. 4
Fig. 4
Comparison of coronary perfusion pressure (mmHg) in each group at four timepoints.
Fig. 5
Fig. 5
Comparison of end-tidal CO2 in each group at four timepoints.
See this image and copyright information in PMC

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