Retinal Hemorrhage After Cardiopulmonary Resuscitation in Children: An Etiologic Reevaluation

Abstract

Retinal hemorrhage detected after cardiopulmonary resuscitation has important medical, social, and legal implications. When a child is brought to the hospital in circulatory arrest, these hemorrhages raise the question of preceding trauma, frequently child abuse.1 Several authors have suggested that retinal hemorrhage may be virtually pathognomonic of child abuse.2,3 We have questioned this belief because our experience, as well as that of others,4,5 suggests that retinal hemorrhage may result from resuscitative efforts. We therefore undertook a prospective study to evaluate whether cardiopulmonary resuscitation can cause retinal hemorrhage. MATERIALS AND METHODS During a 4-month period, all children admitted to the Pediatric Critical Care Medicine Service who underwent cardiopulmonary resuscitation were considered for inclusion in the study.