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J Korean Soc Emerg Med > Volume 32(1); 2021 > Article
Journal of The Korean Society of Emergency Medicine 2021;32(1): 5-10.
다중검출컴퓨터단층촬영을 이용한 복부 팽만에 따른 적절한 흉부압박 위치 분석
이진희 , 고찬영 , 조현영
단국대학교 의과대학 응급의학교실
Analysis of proper chest compression position according to abdominal distension using multi-detector computed tomography
Jin Hee Lee , Chan Young Koh , Hyun Young Cho
Department of Emergency Medicine, Dankook University College of Medicine, Cheonan, Korea
Correspondence  Chan Young Koh ,Tel: 041-550-6840, Fax: 041-550-7054, Email: suepunk@naver.com,
Received: October 16, 2020; Revised: November 10, 2020   Accepted: November 11, 2020.  Published online: February 26, 2021.
ABSTRACT
Objective:
The purpose of this study was to analyze the effect of abdominal distension on proper chest compression position selection during the use of multi-detector computed tomography (MDCT).
Method:
Fifty-eight patients who underwent thoraco-abdominal MDCT for the diagnosis of aortic dissection from January 2013 to August 2018 were included in the study. Abdominal distension was defined as a condition in which the area around the navel in the supine position was higher than the lower half of the sternum. The left ventricle maximal diameter (LVMD) level was scored based on the vertebral body using MDCT. The distance from the end of the sternum (Se), the middle of the lower half of the sternum (Sm), and the upper edge of the liver (Lu) to the LVMD were measured and analyzed.
Results:
The LVMD level was significantly higher in the abdominal distension group than in the non-abdominal distension group (1.74±1.39 vs. 2.77±1.33, P=0.007). The difference was about 1/2 of the height of a vertebral body, i.e. 1.2 cm. In the abdominal distension group, Lu was higher (19.6±18.0 vs. 29.2±13.1, P=0.034) and the distance from LVMD to Sm was shorter than in the non-abdominal distension group (36.3±17.5 vs. 45.8±11.5, P=0.027).
Conclusion:
Abdominal distension alters the position of the heart through the elevation of the diaphragm. Therefore, when performing chest compressions in patients with cardiac arrest, it is necessary to select a chest compression location based on the presence or absence of abdominal distension.
Key words: Cardiopulmonary resuscitation; Tomography; Sternum; Abdomen
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