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- W2009351611 abstract "Cardiopulmonary resuscitation can result in trauma to abdominal organs. We report two cases of splenic rupture causing life threatening haemorrhage.Unexplained hypotension after cardiopulmonary resuscitation might be due to intra-abdominal trauma and concealed haemorrhageCase 1— A 64 year old woman who had undergone coronary artery bypass grafting 10 years previously had a cardiorespiratory arrest at a railway station late one night. Cardiopulmonary resuscitation was started immediately by bystanders and continued for 20 minutes until paramedics arrived. Ventricular fibrillation was confirmed, and she was externally defibrillated. On arrival at hospital she was alert and breathing spontaneously but hypotensive with a blood pressure of 80/40 mm Hg and a sinus tachycardia of 100 beats/min. Clinical examination suggested hypovolaemia with lowered central venous pulse pressure, normal heart sounds, and clear breath sounds. Electrocardiography confirmed an acute inferior myocardial infarction. Thrombolysis was not given because of prolonged resuscitation. She clinically improved on challenge with intravenous fluid. The central venous pulse became visible and her blood pressure rose to 120/70 mm Hg. Over the next hour progressive hypotension recurred, once again with clinical evidence of hypovolaemia. Blood pressure was restored with further intravenous fluid. An echocardiogram excluded major pericardial effusion, showing a non-dilated left ventricle with inferior wall akinesia and overall moderate function. At this stage the patient complained of left sided abdominal pain, with tenderness elicited over the left hypochondrium. Chest x ray films taken in the erect position showed no evidence of rib fractures or subdiaphragmatic gas. Ultrasonography showed …" @default.
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- W2009351611 title "Lesson of the week: Splenic trauma complicating cardiopulmonary resuscitation" @default.
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- W2009351611 doi "https://doi.org/10.1136/bmj.322.7284.480" @default.
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