Incidencia y variables asociadas de lesiones graves secundarias a la reanimación cardiopulmonar y estudio de su efecto hemodinámico adverso

Identificador:  TDX:3090

Handle: https://hdl.handle.net/20.500.11797/TDX3090

Autors:  Jarosch, Youcef Azeli

Resum:
One of the main challenges in cardiopulmonary resuscitation (CPR) techniques is maintaining cardiac output and preventing its impairment, which may give the victim more time to offer other therapies. Chest injuries secondary to CPR are common but little is known about their clinical relevance. The objective of this doctoral thesis is to know the incidence and associated variables of serious injuries secondary to CPR and to determine their adverse hemodynamic effect. This doctoral thesis is presented on the basis of a compendium of three scientific publications. The first publication describes the design of the Tarragona Clinical Pathology Registry (ReCaPTa), a prospective registry of out-of-hospital cardiac arrests for the study of sudden cardiac death, carried out in the region of Tarragona and which has multiple sources of information. The second publication includes the results of the incidence and variables associated with serious injuries secondary to manual CPR performed thanks to a specific autopsy protocol. The third publication studies the haemodynamic effect of serious thoracic injuries secondary to CPR by reviewing the literature and using a theoretical approach based on the Campbell diagram. Serious injuries secondary to CPR are frequent, and are associated with a thoracic circumference greater than 101 cm and with the female gender. The thorax with serious thoracic injuries presents a deterioration of the integrity of its mechanical properties. The representation of the effect of serious thoracic injuries on Campbell's diagram shows that they have an adverse haemodynamic effect during CPR.