Cardiopulmonary Resuscitation Complicated by Traumatic Hepatic Laceration: A Case Report and Review of Literature
Bibliographic record
Abstract
We present an interesting case of a 63-year-old patient who was having lunch with friends in a restaurant when, suddenly, bystanders witnessed him “seize” for 1- minute, after which he became he had a 1-minute witnessed “seizure” followed by unresponsive and pulseless. Cardiopulmonary resuscitation (CPR) was initially performed by these bystanders at the scene, and then subsequently by EMS personnel, who achieved return of spontaneous circulation (ROSC) in the field. The patient was emergently transferred to the hospital where he remained hemodynamically unstable requiring multiple pressors. Due to an acute drop in hematocrit, along with metabolic acidosis, a computed tomography (CT) scan of the abdomen and pelvis was performed. which The scan revealed a large volume of intraperitoneal hemoperitoneum which was largely attributed to CPR. The patient He underwent an exploratory laparotomy during which and the hepatic laceration was repaired and the abdomen was packed. Intraoperatively and postoperatively, the patient remained hemodynamically unstable developing multi-organ failure and requiring multiple products including fresh frozen plasma, packed red blood cells, and cryoprecipitate. Electroencephalogram (EEG) results were consistent with anoxic brain injury and the patient’s family opted for comfort care measures only and he expired the next day. Although CPR induced injuries to hepatic structures have scarcely been reported in the literature, this may underestimate their true incidence given the high mortality rate of sudden cardiac arrest requiring CPR. Our case demonstrates that intra-abdominal trauma following CPR, though rare, must needs to always be considered taken into account. and a Importantly, a high index of clinical suspicion is often necessary to make an early diagnosis of liver trauma as a potential life-threatening complication of CPR. J Med Cases. 2017;8(3):93-97 doi: https://doi.org/10.14740/jmc2775w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.006 | 0.006 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".