Post-resuscitation pneumothorax: retrospective analysis of incidence, risk factors and outcome-relevance

• Published in: Scandinavian journal of trauma, resuscitation and emergency medicine Vol. 32; no. 1; pp. 82 - 8
• Main Authors: Auinger, Daniel, Hötzer, David, Zajic, Paul, Orlob, Simon, Heschl, Stefan, Fida, Stephanie, Zoidl, Philipp, Honnef, Gabriel, Friedl, Herwig, Smolle-Jüttner, Freyja-Maria, Prause, Gerhard
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 05-09-2024; Springer Nature B.V; BMC
• Subjects: Aged; Aged, 80 and over; Austria - epidemiology; Cardiac arrest; Cardiopulmonary resuscitation; Cardiopulmonary Resuscitation - methods; Care and treatment; Complications and side effects; CPR; CPR (First aid); CPR-related injuries; Drug overdose; Electrocardiography; Emergency medical care; Emergency services; Female; Hospitals; Humans; Incidence; Lung diseases; Male; Middle Aged; Out-of-hospital cardiac arrest; Out-of-Hospital Cardiac Arrest - epidemiology; Out-of-Hospital Cardiac Arrest - therapy; Patient outcomes; Patients; Pneumothorax; Pneumothorax - epidemiology; Pneumothorax - etiology; Regression analysis; Retrospective Studies; Risk Factors; Statistics; Thoracic surgery; Ultrasonic imaging; Austria; Out-of-hospital cardiac arrest; Pneumothorax; CPR-related injuries; Cardiopulmonary resuscitation
• ISSN: 1757-7241; 1757-7241
• DOI: 10.1186/s13049-024-01260-8

Pneumothorax may occur as a complication of cardiopulmonary resuscitation (CPR) and could pose a potentially life-threatening condition. In this study we sought to investigate the incidence of pneumothorax following CPR for out-of-hospital cardiac arrest (OHCA), identify possible risk factors, and elucidate its association with outcomes.
This study was a retrospective data analysis of patients hospitalized following CPR for OHCA. We included cases from 1st March 2014 to 31st December 2021 which were attended by teams of the physician staffed ambulance based at the University Medical Centre Graz, Austria. Chest imaging after CPR was reviewed to assess whether pneumothorax was present or not. Logistic regression analysis was performed to identify factors for the development of pneumothorax relevant and to assess its association with outcomes [survival to hospital discharge and cerebral performance category (CPC)].
Pneumothorax following CPR was found in 26 out of 237 included cases (11.0%). History of obstructive lung disease was significantly associated with presence of pneumothorax after CPR. This subgroup of patients (n = 61) showed a pneumothorax rate of 23.0%. Pneumothorax was not identified as a relevant factor to predict survival to hospital discharge or favourable neurological outcome (CPC1 + 2).
Pneumothorax may be present in greater than one in ten patients hospitalized after CPR for OHCA. Pre-existent obstructive pulmonary disease seems to be a relevant risk factor for development of post-CPR pneumothorax.
gov ID: NCT06182007 (retrospectively registered).
NCT06182007 (retrospectively registered).