Impact of anthropometric factors on chest compression depth during CPR provided by children aged 11-14 in a community-wide study

Objective: To assess the depth of chest compressions (CC) provided by schoolchildren and their relation with providers's anthropometric characteristics. Methods: We organized 1-hour hands-on training sessions for 11-14y.o. in volunteering schools. After training, willing subjects performed 2 min of recorded continuous CCs by means of Laerdal Resusci Anne (R) with CPRMeter2 (R), with visual feedback. Compression pace was given by metronome; instructors supervised the correct body position. Collected data included age, sex, as well as measured body weight and height. Results: We analyzed records from N = 702 children (mean age: 12.76 +/- 1.02 years, 379 (51.63%) boys) out of 761 participating in the study. Their mean median compression depth (MCD) was 46.70 +/- 7.74 mm, which was below minimal effective CC depth advised by current guidelines (50 mm). This corresponded to low mean fraction of CCs >= 50 mm (CCF >= 50 mm, 42.86 +/- 33.67%), and only 42.88% of children achieving at least 50% of compressions >= 50 mm. Boys had significantly higher mean MCD and CCF >= 50 mm than girls (MCD: 49.34 +/- 7.05 mm vs 45.97 +/- 8.07 mm, p < 0.0001; CCF >= 50 mm: 50.23 +/- 32.90% vs 40.40 +/- 34.97%, p < 0.0001). Age differentiated children who achieved at least 50% of compressions >= 50 mm from those who did not with AUC of 0.69 (for cut-off of 12.1 years: 85% sensitivity, 41% specificity), whereas weight offered an improved prediction (AUC 0.74; for cut-off 44.8 kg: 77.4% sensitivity, 61.1% specificity). Conclusions: Sex, age and anthropometric factors are significant CC quality factors. Children with higher body weight are more likely to deliver CCF50%>= 50 mm. Among the studied population, children >= 12 years old provided more effective chest compressions.