{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T03:02:25Z","timestamp":1760151745312,"version":"build-2065373602"},"reference-count":21,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,4,7]],"date-time":"2022-04-07T00:00:00Z","timestamp":1649289600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Chest compressions during cardiopulmonary resuscitation (CPR) may be associated with iatrogenic chest wall injuries. The extent to which these CPR-associated chest wall injuries contribute to a delay in the respiratory recovery of cardiac arrest survivors has not been sufficiently explored. In a single-center retrospective cohort study, surviving intensive care unit (ICU) patients, who had undergone CPR due to medical reasons between 1 January 2018 and 30 June 2019, were analyzed regarding CPR-associated chest wall injuries, detected by chest radiography and computed tomography. Among 109 included patients, 38 (34.8%) presented with chest wall injuries, including 10 (9.2%) with flail chest. The multivariable logistic regression analysis identified flail chest to be independently associated with the need for tracheostomy (OR 15.5; 95% CI 2.77\u201386.27; p = 0.002). The linear regression analysis identified pneumonia (\u03b2 11.34; 95% CI 6.70\u201315.99; p &lt; 0.001) and the presence of rib fractures (\u03b2 5.97; 95% CI 1.01\u201310.93; p = 0.019) to be associated with an increase in the length of ICU stay, whereas flail chest (\u03b2 10.45; 95% CI 3.57\u201317.33; p = 0.003) and pneumonia (\u03b2 6.12; 95% CI 0.94\u201311.31; p = 0.021) were associated with a prolonged duration of mechanical ventilation. Four patients with flail chest underwent surgical rib stabilization and were successfully weaned from the ventilator. The results of this study suggest that CPR-associated chest wall injuries, flail chest in particular, may impair the respiratory recovery of cardiac arrest survivors in the ICU. A multidisciplinary assessment may help to identify patients who could benefit from a surgical treatment approach.<\/jats:p>","DOI":"10.3390\/jcm11082071","type":"journal-article","created":{"date-parts":[[2022,4,7]],"date-time":"2022-04-07T13:39:51Z","timestamp":1649338791000},"page":"2071","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Chest Compression-Related Flail Chest Is Associated with Prolonged Ventilator Weaning in Cardiac Arrest Survivors"],"prefix":"10.3390","volume":"11","author":[{"given":"Kevin","family":"Kunz","sequence":"first","affiliation":[{"name":"Medical Intensive Care Unit, University Hospital Leipzig, 04103 Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2345-756X","authenticated-orcid":false,"given":"Sirak","family":"Petros","sequence":"additional","affiliation":[{"name":"Medical Intensive Care Unit, University Hospital Leipzig, 04103 Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Ewens","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, 04103 Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3321-1598","authenticated-orcid":false,"given":"Maryam","family":"Yahiaoui-Doktor","sequence":"additional","affiliation":[{"name":"Medical Faculty, Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, 04107 Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timm","family":"Denecke","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, 04103 Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0070-3406","authenticated-orcid":false,"given":"Manuel Florian","family":"Struck","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, University Hospital Leipzig, 04103 Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4867-8884","authenticated-orcid":false,"given":"Sebastian","family":"Kr\u00e4mer","sequence":"additional","affiliation":[{"name":"Department of Visceral, Transplant, Thoracic and Vascular Surgery, Division of Thoracic Surgery, University Hospital Leipzig, 04103 Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.resuscitation.2021.02.009","article-title":"European Resuscitation Council Guidelines 2021: Basic Life Support","volume":"161","author":"Olasveengen","year":"2021","journal-title":"Resuscitation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.resuscitation.2021.02.012","article-title":"European Resuscitation Council and European Society of Intensive Care Medicine Guidelines 2021: Post-resuscitation care","volume":"161","author":"Nolan","year":"2021","journal-title":"Resuscitation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.1111\/1556-4029.13411","article-title":"Flail Chest Following Failed Cardiopulmonary Resuscitation","volume":"62","author":"Thompson","year":"2017","journal-title":"J. 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