Parenchymal lung injuries related to standard cardiopulmonary resuscitation.

Abstract

OBJECTIVES:

We analyzed chest computed tomographic scan to evaluate parenchymal lung injury and its clinical significance in patients who received standard cardiopulmonary resuscitation and were resuscitated from cardiac arrest.

METHODS:

We enrolled nontraumatic out-of-hospital cardiac arrest patients older than 19 years who had been admitted to the emergency department in cardiac arrest and successfully resuscitated after cardiopulmonary resuscitation. Chest computed tomography was obtained immediately after return of spontaneous circulation (ROSC). To allocate the area of lung contusion, we divided both hemithoraces into 3 regions longitudinally, and each part was subdivided into 4 segments except the lower part of the left lung. To stratify the severity of lung contusion, each segment was scored depending on the area of lung contusion. Oxygen index (OI) was measured at the time of ROSC, 24, 48, and 72 hours and 1 week after cardiac arrest.

RESULTS:

Lung contusion was developed in 37 (41%) patients and median lung contusion score (LCS) was 17 (12-26). Lung contusion was not associated with hospital mortality (P = .924) or length of intensive care unit stay (P = .446). The OI at the time of ROSC was lower in patients with LCS greater than 23 than that in patients with LCS less than or equal to 23 (126 [93-224] vs 278 [202-367]; P = .008); however, the OI at the other timelines was not different between patients with LCS greater than 23 and patients with LCS less than or equal to 23.

CONCLUSION:

Extensive lung contusion is associated with a lower oxygenation index at the time of ROSC, but did not affect the resuscitation outcome.

• Authors: Kyoung-Chul Cha, Yong Won Kim, Hyung Il Kim, Oh Hyun Kim, Yong Sung Cha, Hyun Kim, Kang Hyun Lee, Sung Oh Hwang
• Journal: The American journal of emergency medicine (Am J Emerg Med) Vol. 35 Issue 1 Pg. 117-121 (Jan 2017) ISSN: 1532-8171 [Electronic] United States
• PMID: 28029486 (Publication Type: Journal Article)
• Copyright: Copyright © 2016 Elsevier Inc. All rights reserved.

Topics

• Aged
• Cardiopulmonary Resuscitation (adverse effects, methods)
• Cerebrovascular Circulation
• Female
• Humans
• Lung Injury (diagnostic imaging, etiology, pathology)
• Male
• Middle Aged
• Out-of-Hospital Cardiac Arrest (therapy)
• Regional Blood Flow
• Republic of Korea
• Retrospective Studies
• Tomography, X-Ray Computed
• Treatment Outcome