Multidetector CT finds skeletal chest injuries after CPR

Last Updated: 2011-07-26 15:06:07 -0400 (Reuters Health)

NEW YORK (Reuters Health) - When conventional x-rays miss skeletal chest injuries caused by cardiopulmonary resuscitation (CPR), multidetector CT (MDCT) can usually find them, a Korean study shows.

The researchers stopped short of recommending MDCT in all patients who survive CPR, instead merely calling it "useful" compared to x-rays for evaluating chest injuries secondary to CPR and for evaluating fracture-related complications.

This is the first study to compare MDCT to radiography in this setting, they reported online June 12th in Resuscitation.

Dr. Hyuk Jun Yang and colleagues from Gachon University Gil Hospital in Incheon studied 40 adults who were successfully resuscitated for nontraumatic cardiac arrest in the preceding 24 hours.

MDCT showed 173 rib fractures and 12 sternal fractures in 26 patients. Radiography detected rib fractures in only 10 patients and failed to detect any sternal fractures.

Most cases involved bilateral rib fractures, and most sternal fractures occurred in the middle and lower third of the sternum.

Six patients had rib fracture-related complications, including chest wall hematoma (4 patients), pneumothorax (1 patient), and subclavian vein injury (1 patient). In addition, six patients had secondary signs of sternal fracture (retrosternal or mediastinal hematoma).

"Chest radiography remains the primary screening study for assessing patients who have chest trauma," the researchers conclude. "However, the use of MDCT has increased for these patients because it enables thinner sections with greater speed, and this allows higher quality axial images and multiplanar reconstructions."


Resuscitation 2011.

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