Effect of Differences in Thorax Volume and Dimensions on CPR-related Injuries

To investigate the relationship between the prevalence of cardiopulmonary resuscitation (CPR) related thoracic injury and patients' thoracic volume and dimensions.

Observational study.

Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Turkey, from August 2015 to August 2019.

Patients, who were in hospital due to a non-traumatic cause, had experienced cardiac arrest and subsequently had a post-CPR thorax tomography, were included in the study. Thorax dimensions were measured on sagittal, transverse, and longitudinal axes, while thorax volumes were calculated using a 3D computer programme. This data was later compared to trauma findings.

A total of 246 patients were included in the study. The sagittal measurements ranged from 130 - 302 mm, with an average of 228.42 ± 25.61 mm; the transverse measurements ranged from 160-293 mm, average 238.60 ± 22.25 mm, and longitudinal measurements ranged from 99-259 mm, average 187.94 ± 29.76 mm; while thorax volumes were between 4670 - 21512 cc, with an average of 10118.19 ± 2438.01 cc. Trauma was present in 34.1% of patients.  Sagittal, longitudinal dimensions, and thorax volume were lower for the group positive for trauma compared to the non-trauma group (p=0.019, p=0.023 and p=0.002). Thorax volume and longitudinal dimensions were found to be lower in patients who experienced rib fractures (p=0.021, p<0.05). Sagittal dimensions were also found to be significantly lower in the group with pneumothorax (p<0.05).

Lower thorax volume and sagittal dimensions were associated with an increased prevalence of traumatic findings. Key Words: Cardiopulmonary resuscitation, Thoracic injuries, Pneumothorax, Rib fracture.