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41. Gastric Trauma and Pulmonary Aspiration at Autopsy After Cardiopulmonary Resuscitation

Published online by Cambridge University Press:  28 June 2012

William B. Felegi ,
Richard L. Doolittle ,
Alfred S. Conston  and
Stephen V. Chandler
William B. Felegi
Affiliation:
Department of Emergency Medicine, Morristown Memorial Hospital, Morristown, New Jersey, USA
Richard L. Doolittle
Affiliation:
Department of Biology, Rochester Institute of Technology, Rochester, New York, USA
Alfred S. Conston
Affiliation:
Department of Pathology, Somerset Medical Center, Somerville, New Jersey, USA
Stephen V. Chandler
Affiliation:
Department of Pathology, Somerset Medical Center, Somerville, New Jersey, USA
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Purpose: To determine the prevalence of gastric trauma and pulmonary aspiration after cardiopulmonary resuscitation (CPR) and to examine factors which may be associated with increased prevalence of these complications.

Methods: Retrospective review of 1,928 consecutive autopsy reports in a suburban teaching hospital from January 1, 1977 – June 1, 1986 of which 860 received CPR and 1,037 did not. Of the 860 who received CPR, 527 received prehospital CPR and 333 arrested in hospital and received only hospital CPR. Thirty-one cases were excluded because of inability to accurately examine the stomach.

Results: There were 3 cases of stomach mucosal laceration and 4 cases of through and through laceration of the stomach in the CPR group and only one occurred in the non-CPR group (p <0.03). All gastric trauma in the CPR group occurred in the prehospital group (p <0.05). Pulmonary aspiration occurred in 31% of prehospital CPR patients and only 10% of hospital CPR patients (p <0.0001). The prehospital group differed from the hospital group in the following factors: longer basic life support times without intubation, 14.0 minutes vs. 2.0 minutes (p <0.0001) and longer total resuscitation time 46.9 minutes vs. 34.6 minutes (p <0.0001).

Type
Oral Presentations
Information
Prehospital and Disaster Medicine , Volume 11 , supplement S2: Abstracts of Scientific Papers. The Twelth Annual Conference and Scientific Assembly of the National Association of EMS Physicians, 13-15 July 1996, Loews Coronado Bay Resort, San Diego, California, USA , September 1996 , pp. S30
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1996