Unexpected High Prevalence of Infant Resuscitation Related Rib Fractures Identified Radiologically in Postmortem Population

Rib fractures from chest compression during cardiopulmonary resuscitation in infants are suggested to be uncommon compared to adults. However, the actual prevalence is not well documented and there are only limited studies, particularly after the changes to recommended resuscitation methods in infants. Furthermore, it is unclear whether there is a difference in prevalence between younger and older infants. This 6-year retrospective study reviewed 94 infants (between 4 weeks and 1 year old) who had received resuscitation chest compressions around the time of death and showed 20% (19 out of 94) had radiological evidence of rib fractures. It occurred either in one or multiple ribs, one or both sides, involved almost exclusively anterior and sometimes lateral segments of the ribs, and was seen from the 2nd to 7th ribs. There was no statistical evidence to suggest a predisposition in younger infants to have resuscitation related rib fractures. Further studies are recommended to investigate what the best modality is in recognising these fractures, and to explore any underlying predisposing factors.