In this case report two patients, having severe intraabdominal injuries after cardiopulmonary resuscitation(CPR) with the LUCAS system, are presented. They bothunderwent surgical intervention. Severe intra-abdominalinjuries following manual CPR are rare, but little is knownabout the incidence of these injuries associated withmechanical CPR. We have reviewed the literature on clinicaloutcome and adverse events after out-of-hospital cardiacarrest with LUCAS CPR and manual CPR, and our conclusionis, that more research is needed to establish the safety ofmechanical chest compression systems.