The Effect of Chest Wall Thickness on Return of Spontaneous Circulation in Non-Traumatic Cardiac Arrest Patients

Abstract

Aim: Prior studies have investigated the association between return of spontaneous circulation (ROSC) and factors that included age, cardiopulmonary resuscitation (CPR) duration, initial rhythm. However, it remains unknown whether there is an association between ROSC and chest wall thickness (CWT).Materials and Methods: This is a prospective single-center study that included patients over 18 years of age with non-traumatic out-of-hospital cardiac arrest (OHCA) or had cardiac arrest in the emergency department. Demographic data of patients, initial cardiac arrest rhythm, place where cardiac arrest occurred, duration of arrest before CPR, whether pre-hospital resuscitation was applied, intubation time, tube diameter, how many joules of shock were delivered, amount of adrenaline and antiarrhythmic drug administration, duration of CPR, whether ROSC was achieved, patient outcome, and CWT measured by ultrasonography were recorded.Results: A total of 112 patients included in the study. Median age was 67.5 (IQR=21) years and 59.8% were male. Sixty-five (58%) of the patients had an OHCA. In 74.1% of the patients, the first detected rhythm was found to be non-shockable (p=0.556). Of 112 patients, 49.1% achieved ROSC. The rate of discharge from the hospital was 5.4%. The median CWT at the 3rd intercostal space right midclavicular line was higher in patients with ROSC with shockable rhythm than in patients without ROSC (24.6 mm vs 19.3 mm; p=0.036).Conclusion: There is no significant association between CWT and ROSC in cardiac arrest patients.