The mechanism of pericardial rupture associated with cardiopulmonary resuscitation involving chest compression

2019 Fiscal Year Final Research Report

• Project/Area Number: 16K09222
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Legal medicine
• Research Institution: Nippon Medical School
• Principal Investigator: OKUDA Takahisa 日本医科大学, 医学部, 准教授 (20620305)
• Co-Investigator(Kenkyū-buntansha): 赤石 諭史 日本医科大学, 医学部, 准教授 (10373010) ; 早川 秀幸 日本医科大学, 大学院医学研究科, 研究生 (10373052) ; 高成 広起 徳島大学, ポストLEDフォトニクス研究所, 特任講師 (70723253) ; 秋元 正宇 日本医科大学, 医学部, 教授 (90287673) ; 奥山 みなみ 大分大学, 医学部, 助教 (50756781)
• Project Period (FY): 2016-04-01 – 2020-03-31
• Keywords: 心嚢破裂 / コンピューターシミュレーション

Outline of Final Research Achievements

Pericardial rupture may be found in autopsy imaging cases undergoing cardiopulmonary resuscitation. The purpose of this study is to clarify the mechanism of pericardial rupture during chest compressions under acute cardiac tamponade using computer simulation. After artificially creating a cardiac tamponade model by cardiac catheterization using a cynomolgus monkey, a two-dimensional FEM analysis model is created based on the obtained image data, and the maximum stress applied to the pericardium using the computer simulation program ADINA (ADINA R & D, Inc.). The site, orientation, and size were analyzed. The results suggested that the most stress is applied to the boundary region between the soft tissue and the pericardium or the nerve-pericardium junction, which is the consistent with the clinical cases.

Free Research Field

法医学

Academic Significance and Societal Importance of the Research Achievements

これまで、救急領域の来院時心肺停止患者のうち、左胸腔に大量血胸を認める患者では急性大動脈解離や大動脈瘤破裂によるものと推定されることが多かったが、上記のメカニズムによるものも含まれている可能性があり、正確な死因究明のための死亡時画像診断読影に資すると期待される。