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Cardiopulmonary resuscitation and rib fractures in infants. A postmortem radiologic-pathologic study
M R Spevak1, P K Kleinman, P L Belanger
1Department of Radiology, University of Massachusetts Medical Center, Worchester 01655.
Insights
Cardiopulmonary resuscitation (CPR) is unlikely to cause rib fractures in infants under one year old. A review of infant autopsies found no rib fractures after CPR, suggesting it is a safe procedure for this age group.
Area of Science:
- Pediatric medicine
- Forensic pathology
- Cardiopulmonary resuscitation research
Background:
- Infant cardiopulmonary resuscitation (CPR) is a critical intervention.
- Concerns exist regarding potential iatrogenic injuries, such as rib fractures, in infants undergoing CPR.
- Establishing the safety profile of CPR in infants is crucial for clinical practice and forensic investigations.
Purpose of the Study:
- To determine the incidence of rib fractures in infants younger than 1 year following cardiopulmonary resuscitation (CPR).
- To assess whether CPR is a likely cause of rib fractures in this vulnerable population.
Main Methods:
- Retrospective review of medical records, skeletal surveys, and autopsy findings.
- Study included 91 infants (under 1 year) without evidence of child abuse who received CPR prior to death.
- Data collected from a medical examiner's office serving a diverse geographic area.
Main Results:
- None of the 91 infants reviewed had evidence of rib fractures.
- No rib fractures were identified through autopsy or postmortem radiographs in infants who underwent CPR.
Conclusions:
- Cardiopulmonary resuscitation (CPR) is unlikely to cause rib fractures in infants younger than 1 year.
- The findings suggest that CPR is a relatively safe procedure concerning rib fracture induction in infants.
Objective:
To determine the incidence of rib fractures visible at autopsy or with postmortem radiographs after cardiopulmonary resuscitation (CPR) in infants younger than 1 year.
Design:
Retrospective review.
Setting:
Medical examiner's office in a county consisting of a medium-sized city, towns, and rural areas.
Patients:
Ninety-one infants (56 males, 35 females; mean age, 2.4 months; age range, 26 hours to 8.5 months) without evidence of child abuse who had undergone CPR before death.
Methods:
Medical records, skeletal surveys, and autopsy results were reviewed.
Results:
No patient had rib fractures.
Conclusions:
Cardiopulmonary resuscitation is unlikely to cause rib fractures in infants.