Abstract
A 53-year-old woman with refractory ventricular fibrillation was brought to our emergency room with witnessed cardiopulmonary arrest. The patient underwent extracorporeal cardiopulmonary resuscitation （ECPR）. The patient went into hemorrhagic shock due to liver injury caused by chest compression. Damage control surgery （DCS） with perihepatic gauze packing （PHP） was performed but bleeding was difficult to control. Hemostasis was achieved by PHP again using an absorbent hemostatic agent. Liver injury as a complication of chest compression is manifested by the use of ECPR and anticoagulants. In case of hemodynamic instability, DCS is an appropriate strategy using PHP as the tactic. Depending on the site of injury and anticoagulation status, direct filling of hemostatic agents to the site of injury and PHP could be considered.
