Liver Hemorrhage Following Mechanical CPR With the Lund University Cardiopulmonary Assist System (LUCAS) Device: A Focused Case Report

Abstract

Cardiac arrest is a leading cause of mortality globally, and mechanical CPR devices like the LUCAS system are designed to improve outcomes by enhancing consistency and reducing rescuer fatigue. However, this case report of a 76-year-old female who suffered cardiac arrest post-flight reveals significant complications associated with mechanical CPR. Despite achieving initial resuscitation, she developed extensive liver damage and additional complications, which ultimately led to her death. This case underscores the importance of precise training and strict adherence to guidelines when using mechanical CPR devices. It highlights that while these devices offer potential benefits, they also pose risks, especially for vulnerable patients, necessitating careful consideration and ongoing evaluation to optimize safety and effectiveness.

Keywords: cardiac arrest management; emergency resuscitation; liver damage; lucas device efficacy; massive pulmonary embolism; mechanical cpr; post-flight cardiac arrest.

Figure 1. 12-lead electrocardiogram showing sinus tachycardia with ST depressions in V5 and V6, occasional premature ventricular complexes, and non-specific ST and T wave abnormalities.

Figure 2. CT angiogram depicting perihepatic and capsular hemorrhage with hemoperitoneum layering in the bilateral paracolic gutters and pelvis. The perihepatic/capsular hemorrhage, as indicated by the green arrow, nearly encircles the liver, with areas up to 3 cm thick anteriorly.

Figure 3. Intraoperative surgical procedure image showing extensive hemorrhage from the liver (green arrow) during the liver packing procedure.