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Increased incidence of CPR-related rib fractures in infants--is it related to changes in CPR technique?

J A Reyes1, G R Somers, G P Taylor

  • 1Division of Pathology, Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada. j.reyes@sickkids.ca

Resuscitation
|March 1, 2011
PubMed

Insights

Infant rib fractures linked to cardiopulmonary resuscitation (CPR) increased significantly after 2005 guideline changes. This finding impacts how clinicians and pathologists evaluate these injuries in infants.

Area of Science:

  • Pediatric Medicine
  • Forensic Pathology
  • Medical Guidelines

Background:

  • A rise in infant autopsy cases showing rib fractures from cardiopulmonary resuscitation (CPR) was observed.
  • This increase prompted an investigation into potential links with updated pediatric resuscitation guidelines.

Purpose of the Study:

  • To determine if the observed increase in infant rib fractures associated with CPR correlates with recent revisions in pediatric resuscitation guidelines.

Main Methods:

  • A retrospective review of autopsy reports was conducted.
  • Data from 571 infants who underwent CPR prior to death between 1997 and 2008 were analyzed.

Main Results:

  • CPR-related rib fractures were identified in 19 infants (3.3%).
  • A statistically significant increase in the frequency of these fractures was noted after the 2005 guideline revisions, with 14 cases occurring between 2006-2008.

Conclusions:

  • Infant rib fractures associated with CPR have become more common since the introduction of new CPR techniques in 2005.
  • These findings necessitate careful consideration by clinicians and pathologists when assessing rib fractures in infants.
Abstract

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