Cardiovascular gas on non-traumatic postmortem computed tomography (PMCT): the influence of cardiopulmonary resuscitation

PURPOSE: The purpose of this study was to investigate the causes of cardiovascular gas (CVG) detected on non-traumatic postmortem computed tomography (PMCT). MATERIALS AND METHODS: PMCT was performed on 247 subjects within two hours of non-traumatic death, including 228 patients who had undergone cardiopulmonary resuscitation (CPR) and 19 patients who had not. We evaluated the incidence and distribution of CVG in four areas of the heart, namely, 1) the upper course of the right atrium (UC-RA), 2) the right atrium, 3) the right ventricle, and 4) the left heart (left atrium, left ventricle, and aorta). RESULTS: CVG was observed in 163 (71%) of the 228 patients who underwent CPR. In those 163 patients, we detected CVG in the UC-RA (103 patients), right atrium (81 patients), right ventricle (94 patients), and left heart (5 patients). Nineteen patients who received no CPR showed no CVG. CONCLUSION: CVG on non-traumatic PMCT is mainly caused by CPR, which is characterized by venous catheterization that permits possible air inflow and by pneumatization of dissolved gas in the blood as a result of cardiac massage.