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Perikardlazeration nach Verwendung einer automatischen externen Reanimationshilfe

Pericardial laceration after using an automated mechanical chest compression device

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Zusammenfassung

Wir berichten über einen 72-jährigen Patienten, der aufgrund eines plötzlichen Herzkreislaufstillstands mithilfe einer automatischen externen Reanimationshilfe (LUCAS2) kardiopulmonal reanimiert wurde. Trotz der Zuführung des Patienten unter fortgesetzten Thoraxkompressionen mittels LUCAS2 konnte auch in der Zentralen Notaufnahme kein Wiedereintritt des Blutkreislaufs erreicht werden. Bei der rechtsmedizinischen Obduktion fanden sich zahlreiche, für die Reanimationsbehandlung mittels automatischen externen Reanimationshilfen typische Befunde. Infolge einer dislozierten Sternumfraktur war es zu einer Lazeration des Perikards gekommen. Todesursächlich war letztendlich eine linksventrikuläre Wandruptur aufgrund eines bereits mehrere Tage zurückliegenden Myokardinfarkts mit Perikardtamponade. Es wird die Inzidenz von mit automatischen externen Reanimationshilfen assoziierten Verletzungen und die Notwendigkeit der regelmäßigen rechtsmedizinischen oder klinisch-pathologischen Obduktion zur Qualitätssicherung diskutiert.

Abstract

We report the case of a 72-year-old patient who underwent cardiopulmonary resuscitation using an automated mechanical chest compression device (LUCAS2) after sudden cardiac arrest. In spite of transporting the patient to the emergency room with continued mechanical chest compressions, recovery of spontaneous circulation was not achieved. During the forensic autopsy, numerous injuries typically associated with mechanical cardiopulmonary resuscitation were detected. A laceration of the pericardial sac was caused by a dislocated fracture of the sternum. Finally, a rupture of the left ventricular heart wall due to a several day old myocardial infarction followed by a cardiac tamponade was determined to be the cause of death. We discuss the incidence of injuries associated with the use of an automated mechanical chest compression device during cardiopulmonary resuscitation and the necessity of regular forensic or clinical–pathological autopsies for quality management.

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Authors and Affiliations

  1. Institut für Rechtsmedizin, Universität Leipzig, Leipzig, Deutschland

    B. Ondruschka, C. Hädrich & J. Dreßler

  2. Zentrale Notaufnahme, Universitätsklinikum Leipzig, Leipzig, Deutschland

    T. Hartwig, A. Gries &  M. Bernhard

Authors
  1. B. Ondruschka
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  2. T. Hartwig
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  3. A. Gries
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  4. C. Hädrich
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  5. J. Dreßler
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  6. M. Bernhard
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Correspondence to M. Bernhard.

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Interessenkonflikt

B. Ondruschka, T. Hartwig, A. Gries, C. Hädrich, J. Dreßler und M. Bernhard geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Ondruschka, B., Hartwig, T., Gries, A. et al. Perikardlazeration nach Verwendung einer automatischen externen Reanimationshilfe. Notfall Rettungsmed 20, 424–429 (2017). https://doi.org/10.1007/s10049-016-0238-6

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  • DOI: https://doi.org/10.1007/s10049-016-0238-6

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