Iatrogene Traumata nach frustraner Reanimation[1]

 

 Buy Article Permissions and Reprints

Zusammenfassung

Reanimationsbemühungen erfordern invasive iatrogene Manipulationen am Patienten. Diese Maßnahmen sind einerseits zur erfolgreichen Wiederbelebung des Patienten unerlässlich, können andererseits aber den Patienten schädigen und den Erfolg der Wiederbelebung negativ beeinflussen. Hierbei wird zwischen häufigen und seltenen Komplikationen unterschieden. Einflussfaktoren sind Dauer und Intensität der Reanimationsmaßnahmen, Alter des Patienten sowie eine gerinnungshemmende Medikation.

Abstract

Resuscitation attempts require invasive iatrogenic manipulations on the patient. On the one hand, these measures are essential for successful survival of the patient, but on the other hand can damage the patient. We differentiate between frequent and rare injuries. Factors of influence are duration and intensity of the resuscitation attempts, age of the patient as well as a coagulate-inhibiting medication.

1 Erstveröffentlichung des Beitrags in der Dtsch Med Wochenschr 2008; 133: 1244–1248.

Literatur

• 1 Larsen R. Kardiopulmonale Reanimation. In: Larsen R, ed Anästhesie (8nd Edition). München, Jena; Urban & Fischer Verlag 2002: 851-900
  Google Scholar
• 2 Saternus K S, Fuchs V. Verletzungen der A. carotis communis durch Reanimationsmaßnahmen.  Z Rechtsmed. 1982;  88 305-311
  PubMedGoogle Scholar
• 3 Jaeger K, Ruschulte H, Osthaus A. et al . Tracheal injury as a sequence of multiple attempts of endotracheal intubation in the course of a preclinical cardiopulmonary resuscitation.  Resuscitation. 2000;  43 147-150
  CrossrefPubMedGoogle Scholar
• 4 Maxeiner H. Weichteilverletzungen am Kehlkopf bei notfallmäßiger Intubation.  Anästh Intensivmed. 1988;  29 42-49
  PubMedGoogle Scholar
• 5 Darok M. Injuries resulting from resuscitation procedures. In: Tsokos M, ed Forensic Pathology Reviews Vol 1. Totowa, NJ; Humana Press Inc 2004: 293-303
  Google Scholar
• 6 Sperry K. Anterior thoracic wall trauma in elderly homicide victims. The „CPR” defense.  Am J Forensic Med Pathol. 1990;  11 50-55
  PubMedGoogle Scholar
• 7 Lederer W, Mair D, Rabl W. et al . Frequency of rib and sternum fractures associated with out-of-hospital cardiopulmonary resuscitation is underestimated by conventional chest X-ray.  Resuscitation. 2004;  60 157-162
  CrossrefPubMedGoogle Scholar
• 8 Price E A, Rush L R, Perper J A. et al . Cardiopulmonary resuscitation-related injuries and homicidal blunt abdominal trauma in children.  Am J Forensic Med Pathol. 2000;  21 307-310
  CrossrefPubMedGoogle Scholar
• 9 Odom A, Christ E, Kerr N. et al . Prevalence of Retinal Hemorrhages in Pediatric Patients After In-Hospital Cardiopulmonary Resuscitation: A Prospective Study.  Pediatrics. 1997;  , DOI: DOI: 10.1542/peds.99.6.e3
  PubMedGoogle Scholar
• 10 Ryan M P, Young S J, Wells D L. Do resuscitation attempts in children who die, cause injury?.  Emerg Med J. 2003;  20 10-12
  CrossrefPubMedGoogle Scholar
• 11 Dirks B, Sefrin P. Reanimation 2006 – Empfehlungen der Bundesärztekammer nach den Leitlinien des European Resuscitation Council.  Dtsch Arztebl. 2006;  103 (34–35) A2263-A2267
  PubMedGoogle Scholar
• 12 Hartoko T J, Demey H E, Rogers P E. et al . Pneumoperitoneum – a rare complication of cardiopulmonary resuscitation.  Acta Anaesth Scand. 1991;  35 235-237
  PubMedGoogle Scholar
• 13 Krause S, Donen N. Gastric rupture during cardiopulmonary resuscitation.  Can Anaesth Soc J. 1984;  31 319-322
  PubMedGoogle Scholar
• 14 Mills S A, Paulson D, Scott S M. et al . Tension pneumoperitoneum and gastric rupture following cardiopulmonary resuscitation.  Ann Emerg Med. 1983;  12 94-95
  CrossrefPubMedGoogle Scholar
• 15 Schvadron E, Moses Y, Weissberg D. Gastric Rupture complicating inadvertent intubation of the esophagus.  Can J Surg. 1996;  39 487-489
  PubMedGoogle Scholar
• 16 Bauer H, Welsch K. Punktions-Techniken in der Notfallmedizin.  Münchener Medizinische Wochenschrift. 1976;  118 567-572
  PubMedGoogle Scholar
• 17 Minor Jr R L, Chandran P K, Williams C L. Rhabdomyolysis and myoglobinuric renal failure following cardioversion and CPR for acute MI.  Chest. 1990;  97 485-486
  CrossrefPubMedGoogle Scholar
• 18 Bode G, Joachim H. Zur Differenzialdiagnose von Unfall- und Reanimationstraumen.  Z Rechtsmed. 1987;  98 19-32
  PubMedGoogle Scholar
• 19 Rabl W, Baubin M, Haid C. et al . Review of active compression-decompression cardiopulmonary resuscitation (ACD-CPR). Analysis of iatrogenic complications and their biomechanical explanation.  Forensic Sci Int. 1997;  89 175-183
  CrossrefPubMedGoogle Scholar
• 20 Klintschar M, Darok M, Radner H. Massive injury to the heart after attempted active compression-decompression cardiopulmonary resuscitation.  Int J Legal Med. 1998;  111 93-96
  CrossrefPubMedGoogle Scholar
• 21 Meron G, Kurkciyan I, Sterz F. et al . Cardiopulmonary resuscitation-associated major liver injury.  Resuscitation. , DOI: DOI: 10.1016/j.resuscitation.2007.05.023
  PubMedGoogle Scholar
• 22 Noffsinger A E, Blisard K S, Balko M G. Cardiac laceration and pericardial tamponade due to cardiopulmonary resuscitation after myocardial infarction.  J Forensic Sci. 1991;  36 1760-1764
  PubMedGoogle Scholar
• 23 Umach P, Unterdorfer H. Organverletzungen durch Reanimationsmaßnahmen.  Beiträge zur Gerichtlichen Medizin. 1980;  38 29-32
  PubMedGoogle Scholar
• 24 Krischer J P, Fine E G, Davis J H. et al . Complications of cardiac resuscitation.  Chest. 1987;  92 287-291
  CrossrefPubMedGoogle Scholar
• 25 Ziegenfuss M D, Mullany D V. Traumatic liver injury complicating cardio-pulmonary resuscitation. The value of a major intensive care facility: a report of two cases.  Crit Care Resusc. 2004;  2 102-104
  PubMedGoogle Scholar
• 26 Kurkciyan I, Meron G, Sterz F. et al . Major bleeding complications after cardiopulmonary resuscitation: impact of thrombolytic treatment.  Journal of Internal Medicine. 2003;  253 128-135
  CrossrefPubMedGoogle Scholar
• 27 Lawes E G, Baskett P J. Pulmonary aspiration during unsuccessful cardiopulmonary resuscitation.  Intensive Care Med. 1987;  13 379-382
  PubMedGoogle Scholar
• 28 Shulman D, Beilin B, Olshwang D. Pulmonary barotrauma during cardiopulmonary resuscitation.  Resuscitation. 1987;  15 201-207
  CrossrefPubMedGoogle Scholar
• 29 Yamaki T, Ando S, Ohta K. et al . CT demonstration of massive cerebral air embolism from pulmonary barotraumas due to cardiopulmonary resuscitation.  J Comput Assist Tomogr. 1989;  13 313-315
  PubMedGoogle Scholar
• 30 Hashimoto Y, Moriya F, Furumiya J. Forensic aspects of complications resulting from cardiopulmonary resuscitation.  Legal Medicine. 2007;  9 94-99
  CrossrefPubMedGoogle Scholar
• 31 Kardiopulmonale Reanimation – Aktuelle Leitlinien des European Resuscitation Council.  Notfall- und Rettungsmedizin. 2006;  9 4-170
  PubMedGoogle Scholar
• 32 Valenzuela T D, Kern K B, Clark L L. et al . Interruptions of chest compressions during emergency medical systems resuscitation.  Circulation. 2005;  112 1259-1265
  CrossrefPubMedGoogle Scholar
• 33 Wik L, Kramer-Johansen J, Myklebust H. et al . Quality of cardiopulmonary resuscitation during out-of-hospital cardiac arrest.  JAMA. 2005;  293 299-304
  CrossrefPubMedGoogle Scholar
• 34 Eldor J, Ofek B, Abramowitz H B. Perforation of oesophagus by tracheal tube during resuscitation.  Anaesthesia. 1990;  45 70-71
  PubMedGoogle Scholar

1 Erstveröffentlichung des Beitrags in der Dtsch Med Wochenschr 2008; 133: 1244–1248.

Dr. med. Claas T. Buschmann

Charité – Universitätsmedizin Berlin, Institut für Rechtsmedizin

Turmstr. 21, Haus L

10559 Berlin

Phone: 030/901728-147

Fax: 030/901728-154

Email: claas.buschmann@charite.de

URL: http://remed.charite.de