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Rare Complication of Cardiopulmonary Resuscitation-Liver Injury
David Hoskovec1,2, Pavol Klobušický2, Adam Pudlač3
11st Department of Surgery, General University Hospital, 128 08 Prague, Czech Republic.
Medicina (Kaunas, Lithuania)
|September 28, 2024
Summary
Liver injury following cardiopulmonary resuscitation (CPR) is rare but deadly. Early signs include cardiopulmonary instability and falling red blood cell counts, necessitating prompt diagnosis and treatment for improved survival.
Area of Science:
- Trauma Surgery
- Critical Care Medicine
- Hepatology
Background:
- Liver injury is an infrequent complication of cardiopulmonary resuscitation (CPR).
- Timely diagnosis and management are critical due to potentially masked clinical signs during cardiac arrest.
- This study examines traumatic liver injuries occurring post-CPR.
Purpose of the Study:
- To report on the incidence and outcomes of severe liver injury following CPR.
- To identify diagnostic indicators and effective treatment strategies for this rare complication.
Main Methods:
- A single-centre retrospective observational study was conducted.
- Analysis included demographic data, resuscitation cause, duration of restoration of spontaneous circulation (ROSC), and surgical approach.
- Nine patients with severe liver injury post-CPR were reviewed.
Main Results:
- Five out of nine patients (55.6%) survived.
- Diagnosis was based on cardiopulmonary instability, falling erythrocyte counts (8/9 cases), and confirmed by CT or ultrasound.
- Surgical repair involved sutures and packing, with planned second-look procedures.
Conclusions:
- Liver injury post-CPR is rare and carries a high mortality rate.
- Key indicators for diagnosis include recurrent cardiopulmonary instability and/or a declining red blood cell count.
- Early diagnosis, prompt imaging (ultrasound, CT), and timely surgical intervention are crucial for survival, alongside the duration of ROSC.
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