LIVER INJURY ASSOCIATED WITH CHEST COMPRESSION IN CARDIOPULMONARY ARREST PATIENTS

Abstract

　　Although chest compression is an effective emergency maneuver for cardiopulmonary arrest (CPA), it carries a risk of complications such as rib fracture, sternal fracture, and organ injury. Two cases of CPA due to pulmonary thromboembolism were admitted to our department. Spontaneous circulation was restored with cardiopulmonary resuscitation (CPR) including chest compression. After use of an anticoagulant drug and indication of veno-arterial extra corporeal membrane oxygenation, contrast-enhanced computed tomography demonstrated infra-diaphragmatic liver injury in both cases. One patient could survive with damage control surgery (DCS), while the other patient could not survive without surgical management. As a conclusion, patients with hemorrhagic diathesis are at critical risk for complications from chest compression. Aggressive treatments, including DCS, may be effective even for patients treated with anticoagulant drugs.