emergenza_massaggio_cardiaco RCP rianimazione cardiopolmonare

5 common side effects of CPR and complications of cardiopulmonary resuscitation

By Cristiano Antonino On Mar 28, 2023

CPR or Cardiopulmonary Resuscitation is an emergency treatment used to restart a person’s heart and breathing during cardiac emergencies

But just how effective is CPR? What are the CPR side effects and common complications? And, if someone is lucky enough to survive a cardiopulmonary emergency, what does that mean for that person’s long-term health?

Cardiac Arrest Statistics

According to the most recent statistical analysis by the American Heart Association, 88% of out-of-hospital cardiac arrests happen at home, where there are no doctors or nurses, which is why it is so important that everyone be skilled in providing CPR.

The rescuer must continue the CPR until the victim has a return of spontaneous circulation or ROSC

The average bystander skilled in CPR can triple a victim’s chance of surviving an out-of-hospital cardiopulmonary emergency.

However, the chances of receiving CPR from a non-professional in an out-of-hospital cardiac arrest situation is only approximately 32%.

Furthermore, of those victims that receive CPR outside of a hospital, less than 8% survive.

According to the National Institute of Health, approximately 15% of patients are resuscitated and survive discharge in a hospital setting.

A number that has remained relatively stable over the past three decades.

So, a 15% chance of survival is not bad.

But what really happens during CPR?

Cardiopulmonary resuscitation (CPR) is a harsh medical intervention with multiple side effects from receiving it.

There are also mechanical chest compression devices that are as effective as properly executed manual compressions and can minimize the impact of performance error and fatigue.

Other Stats:

In the elderly, rib fracture is significantly more common due to the brittleness and weakness of their bones.

Cardiac arrest survivors report cognitive impairment, restricted mobility, depression, and restricted societal participation after hospital discharge.

Neurological status is a major determinant of overall functional outcome.

Post–cardiac arrest care is a critical component of advanced life support.

Most deaths caused by HIBI result from the withdrawal of life-sustaining treatment following prognostication of a poor neurological outcome.

Prospective studies found improved outcomes in patients associated with therapies.

What are the Risks Associated with CPR?

Movie scenes influence many people’s idea of CPR, where successful resuscitation always happens, and people recover swiftly.

But, in reality, this isn’t consistently the case.

The human brain may not supply enough blood flow if the heart isn’t beating properly.

Also, some human brain damage may still occur even if the CPR successfully gets the heart beating again by performing the correct chest compression rate for adults.

In addition, if severe coronary artery disease is present, it can trigger ventricular fibrillation or abnormal heart rhythms.

If you’re in a public area CPR and an automated external defibrillator can help.

On the other hand, if CPR is given and successful, the recovery of cardiac arrest survivors will depend on several things, such as what caused it and how healthy they were when the cardiac arrest happened.

After successful resuscitation, some people will fully recover, but some will still be very unwell and need more treatment.

That’s why post-cardiac arrest care is a critical component of advanced life support.

Unfortunately, there are also cases where some patients will never get back to their health level before the arrest.

In addition, CPR is much less likely to work if you have a long-term or chronic condition or a terminal illness.

Most Common CPR Side Effects Are:

While there is an increased risk of complications with deeper chest compressions, it is vital to realize that CPR-related injuries or CPR side effects were, by and large, not fatal.

Some of the most common complications or CPR side effects of in and out of hospital Cardiopulmonary Resuscitation are the following:

Aspiration & Vomiting
Broken Ribs
Internal Brain Injuries
Abdominal Distension
Aspiration Pneumonia

Aspiration & Vomiting

The most frequent occurrence during CPR is vomiting. It can present a danger to the cardiac arrest victim.

Since the cardiac arrest victim is unconscious, he cannot clear the vomit from his mouth.

If not removed, the victim will likely aspirate (inhale) it into his lungs, blocking the airway and leading to possible infection.

Broken Ribs Bone

A rib fracture is the most common CPR-related injury because the force and deeper chest compressions are likely to break ribs.

Other skeletal chest injury related to chest compressions are sternal fractures.

There are also uncommon complications like:

In adult patients, sternal fractures occur in at least one-fifth of rib fractures and rib or sternal fractures in at least one-third of the patients during conventional CPR. In the elderly, rib fracture is significantly more common due to the brittleness and weakness of their bones. A rib fracture is dangerous because it can puncture or lacerate a lung, the spleen, or the liver. They are also very painful. Therefore, the frequency of rib fractures associated with out-of-hospital setting CPR is underestimated by conventional chest x-ray.

Internal Brain Injuries

Since CPR leaves the brain receiving 5% less oxygen than average, brain damage is possible.

Brain damage will likely happen within 4 to 6 minutes after the heart stops.

This can lead to long-term health complications.

Abdominal Distension

Another common CPR side effect is Abdominal Distension.

As a result of air being forced into the lungs, the abdomen of the cardiac arrest patient usually becomes bloated and full of air during CPR, leading to compression of the lungs, and making ventilation more difficult.

It can also and an increased chance of vomiting.

Aspiration Pneumonia

The result of vomit and foreign objects (like a person’s teeth) being inhaled into the lungs can lead to CPR side effects like aspiration pneumonia.

It can be hazardous to a cardiac arrest patient’s health and could complicate recovery or even be fatal, even if the cardiac arrest victim does survive CPR.

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Overall, these CPR side effects mean that if a person survives CPR, their long-term health could suffer and be alive.

But their overall health and quality of life may be significantly affected.

The psychological ramifications of a near-death experience can affect the victim, leading to stress, anxiety, depression, and other psychological disorders.

What is HIBI?

Hypoxic–ischemic brain injury (HIBI) is the leading cause of death in patients who are comatose after resuscitation from cardiac arrest.

Most deaths caused by HIBI result from the withdrawal of life-sustaining treatment following prognostication of a poor neurological outcome.

A poor neurological outcome—death from a neurological cause, persistent vegetative state, or severe neurological disability—can be predicted in these patients by assessing the severity of HIBI.

Does Cardiac Arrest Survivors get back to normal after CPR?

Unfortunately, most out-of-hospital cardiac arrest victims do not survive after the arrest.

Those with complex medical problems are much less likely to make a full recovery.

It is crucial that you know that patients are often critically unwell after CPR and may need more treatment in a coronary care or intensive care unit to recover.

In addition, cardiac arrest survivors report cognitive impairment, restricted mobility, depression, and restricted societal participation after hospital discharge.

Many patients survive CPR but don’t return to their physical or mental health before CPR.

As a result, some of them may need a lot of rehabilitation.

However, some clinical studies found improved outcomes in patients associated with therapies.

In other cases, some patients go into a coma from which they might not recover or suffer from brain damage.

Frequently Asked Questions:

How long does the brain stay alive after the heart stops?

The brain can survive for up to about six minutes after cardiac arrest.

If CPR is performed within six minutes, the brain may survive the lack of oxygen.

After about six minutes without CPR, the brain begins to die.

What is the survival rate after CPR?

A review of CPR outcomes studies reported that an average of 15% of patients experiencing arrest survive until hospital discharge (3%-27%).

Furthermore, this long-term success rate has remained stable for 30 years.

How long do sternum fractures take to heal?

Most sternal fractures heal on their own without splinting or any other treatment.

However, complete recovery usually takes 8 to 12 weeks.

How long do you do CPR before calling time of death?

Check to see if the victim has a pulse and is breathing. If there is no pulse but the victim is breathing inadequately, provide 30 chest compressions at a rate of 100 to 120 compressions per minute, followed by two rescue breaths. Recheck the breathing and pulse after every 2 minutes.

In most cases longer resuscitation efforts improves the chances of survival of the victim.