Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Mar 31;3(1):27-33.
doi: 10.15441/ceem.16.119. eCollection 2016 Mar.

Estimation of optimal pediatric chest compression depth by using computed tomography

Soo Young Jin  1 , Seong Beom Oh  1 , Young Oh Kim  1
Affiliations

Estimation of optimal pediatric chest compression depth by using computed tomography

Soo Young Jin et al. Clin Exp Emerg Med. .

Abstract

Objective: This study aimed to compare the optimal chest compression depth for infants and children with that of adults when the simulated compression depth was delivered according to the current guidelines.

Methods: A total of 467 consecutive chest computed tomography scans (93 infants, 110 children, and 264 adults) were reviewed. The anteroposterior diameter and compressible diameter (CD) for infants and children were measured at the inter-nipple level and at the mid-lower half of the spine for adults. Compression ratio (CR) to CD was calculated at simulated 1/4, 1/3, and 1/2 antero-posterior compressions in infants and children, and simulated 5- and 6-cm compressions in adults.

Results: In adults, the CRs to CD at simulated 5- and 6-cm compression depth were 41.7±0.16%, 50.0±7.3% respectively. In children and infants, the CRs to CD at 1/3 chest compression were 55.1±2.4% and 51.8±2.4%, respectively, and at 1/2 chest compression, CRs were 82.7±3.7% and 77.7±3.6%, respectively. The CRs to CD of 4-cm compression depth in infants and 5-cm compression depth in children were 74.4±10.9%, 62.5±8.7%, respectively. The CRs to CD for children and infants were significantly higher than in adults (P<0.001). The CR to CD of 4-cm compression depth in children was almost similar to that of 6-cm compression depth in adults (50.0± 6.9% vs. 50.0±7.3%, P=0.985).

Conclusion: Current pediatric guidelines for compression depth are too deep compared to those in adults. We suggest using 1/3 of the anteroposterior chest diameter or about 4 cm in children and less than 4 cm in infants.

Keywords: Chest compression; Computed tomography; Pediatrics.

PubMed Disclaimer

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
Computed tomography scan demonstrating axial image at the mid sternal level and method for calculating compressible, incompressible diameter and antero-posterior diameter. We calculated the compressible diameter by measuring a line drawn perpendicularly from the skin anteriorly to the anterior vertebral body.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Halperin HR, Tsitlik JE, Guerci AD, et al. Determinants of blood flow to vital organs during cardiopulmonary resuscitation in dogs. Circulation. 1986;73:539–50. - PubMed
    1. Kern KB, Lancaster L, Goldman S, Ewy GA. The effect of coronary artery lesions on the relationship between coronary perfusion pressure and myocardial blood flow during cardiopulmonary resuscitation in pigs. Am Heart J. 1990;120:324–33. - PubMed
    1. Paradis NA, Martin GB, Rivers EP, et al. Coronary perfusion pressure and the return of spontaneous circulation in human cardiopulmonary resuscitation. JAMA. 1990;263:1106–13. - PubMed
    1. Idris AH, Becker LB, Ornato JP, et al. Utstein-style guidelines for uniform reporting of laboratory CPR research. A statement for healthcare professionals from a task force of the American Heart Association, the American College of Emergency Physicians, the American College of Cardiology, the European Resuscitation Council, the Heart and Stroke Foundation of Canada, the Institute of Critical Care Medicine, the Safar Center for Resuscitation Research, and the Society for Academic Emergency Medicine. Writing Group. Circulation. 1996;94:2324–36. - PubMed
    1. Kouwenhoven WB, Jude JR, Knickerbocker GG. Closed-chest cardiac massage. JAMA. 1960;173:1064–7. - PubMed

LinkOut - more resources