• Daniel Auinger, David Hötzer, Paul Zajic, Simon Orlob, Stefan Heschl, Stephanie Fida, Philipp Zoidl, Gabriel Honnef, Herwig Friedl, Freyja-Maria Smolle-Jüttner, and Gerhard Prause.
• Division of Anaesthesiology and Intensive Care Medicine 1, Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Styria, Austria. daniel.auinger@medunigraz.at.
• Scand J Trauma Resus. 2024 Sep 5; 32 (1): 8282.

BackgroundPneumothorax 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.MethodsThis 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)].ResultsPneumothorax 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).ConclusionsPneumothorax 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.Clinicaltrialsgov ID: NCT06182007 (retrospectively registered).Trial RegistrationNCT06182007 (retrospectively registered).© 2024. The Author(s).

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