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Comparison of relative and actual chest compression depths during cardiac arrest in children, adolescents, and young adults.

Abstract：

AIM:Cardiopulmonary resuscitation (CPR) guidelines recommend specific chest compression (CC) target depths for children. We quantitatively describe relative anterior-posterior diameter (APD) depth, actual depth, and force of CCs during real CPR events in children. METHODS:CC depth and force were recorded during real CPR events in children ≥8 years using FDA-approved CC sensor. Patient chest APD was measured at conclusion of each CPR event. CC data was stratified and analyzed according to age (pre-puberty, 8-14 years; post-puberty, 15+ years). Relative (% APD) and actual CC depth, corrected for mattress deflection, were assessed and compared with American Heart Association (AHA) 2005 and 2010 pediatric CPR guidelines. RESULTS:35 events in 32 subjects included 16,158 CCs for data analysis: 16 pre-puberty (CCs=7484, age 11.9±2 years, APD 164.6±25.1 mm); 19 post-puberty (CCs=8674, age 18.0±2.7 years, APD 196.5±30.4 mm). After correction for mattress deflection, 92% of CC delivered to pre-puberty were <1/3 relative APD and 60% of CC were <38 mm actual depth. Mean actual CC depth (36.2±9.6 mm vs. 36.8±9.9 mm, p=0.64), mean relative APD (22.5%±7.0% vs. 19.5±6.7%, p=0.13), and mean CC force (30.7±7.6 kg vs. 33.6±9.4 kg, p=0.07) were not significantly less in pre-puberty vs. post-puberty. CONCLUSIONS:During in-hospital cardiac arrest of children ≥8 years, CCs delivered by resuscitation teams were frequently <1/3 relative APD and <38 mm actual depth after mattress deflection correction, below pediatric and adult target guidelines. Mean CC actual depth and force were not significantly different in pre-puberty and post-puberty. Additional investigation to determine depth of CCs to optimize hemodynamics and outcomes is needed to inform future CPR guidelines.

journal_name

Resuscitation

journal_title

Resuscitation

authors

Niles DE,Nishisaki A,Sutton RM,Nysæther J,Eilevstjønn J,Leffelman J,Maltese MR,Arbogast KB,Abella BS,Helfaer MA,Berg RA,Nadkarni VM

doi

10.1016/j.resuscitation.2011.10.014

subject

Has Abstract

pub_date

2012-03-01 00:00:00

pages

320-6

issue

eissn

0300-9572

issn

1873-1570

pii

S0300-9572(11)00613-7

journal_volume

pub_type

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Comparison of relative and actual chest compression depths during cardiac arrest in children, adolescents, and young adults.