• Resuscitation · Aug 2019

    The effects of thoracic cage dimension and chest subcutaneous adipose tissue on outcomes of adults with in-hospital cardiac arrest: A retrospective study.

    • Jun-Zhao Liu, Sheng Ye, Tao Cheng, Tian-Yong Han, Qin Li, Rui-Xin Li, Zhuo Zhang, Tong-Yao Li, Ya-Rong He, Zhi Zeng, and Yu Cao.
    • Emergency Department, West China Hospital, Sichuan University, 37 Guoxue Road, Chengdu, Sichuan, China.
    • Resuscitation. 2019 Aug 1; 141: 151-157.

    BackgroundThe associations between thoracic cage dimension, chest subcutaneous adipose tissue (SAT) depth and outcomes of adults with in-hospital cardiac arrest (IHCA) remain unknown.MethodsWe retrospectively evaluated IHCA patients between January 2016 and October 2017. The thoracic cage transverse diameter, internal AP diameter, cross-sectional area, anterior and posterior SAT depths were measured in computed-tomography (CT) images. Using logistic regression models, we determined the adjusted associations between thoracic cage dimension, SAT depths and the prognosis for IHCA. The primary outcome was sustained return of spontaneous circulation (ROSC) and the secondary outcome was survival to hospital discharge.ResultsAmong 423 IHCA patients, 258 patients achieved ROSC and 70 survived to discharge. Smaller cross-sectional area and posterior SAT depth were significantly related to ROSC. Smaller posterior SAT depth was associated with ROSC. After multivariate adjustment, the smaller cross-sectional area was independently associated with ROSC (Odds ratio [OR] 0.99, 95% confidence interval [95%CI] 0.99-1.00; p = 0.008) and survival to discharge (OR 0.99, 95%CI 0.98-1.00; p = 0.024), and the smaller posterior SAT depth was independently related to ROSC (OR 0.65, 95%CI 0.44-0.96; p = 0.030), whereas no relation to survival to discharge was found.ConclusionsIn adults with IHCA, the smaller thoracic cage dimension and posterior SAT depth are associated with better survival. An adjustable compression depth based on the thoracic cage dimension might be better than the "one-size-fits-all" compression depth for resuscitating CA patients. In addition, physicians should pay extra attention to compression efficacy when resuscitating obese patients.Copyright © 2019 Elsevier B.V. All rights reserved.

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