Verification of the Optimal Chest Compression Depth for Children in the 2015 American Heart Association Guidelines: Computed Tomography Study

被引：7

作者：

Kim, Yong Hwan ^{[1
,8
]}

Lee, Jun Ho ^{[1
,8
]}

Cho, Kwang Won ^{[1
,8
]}

Lee, Dong Woo ^{[1
,8
]}

Kang, Mun Ju ^{[1
,8
]}

Lee, Kyoung Yul ^{[2
,8
]}

Byun, Joung Hun ^{[3
,8
]}

Lee, Young Hwan ^{[4
,6
,8
]}

Hwang, Seong Youn ^{[1
,8
]}

Lee, Na Kyoung ^{[5
,7
,8
]}

机构：

[1] Sungkyunkwan Univ, Samsung Changwon Hosp, Dept Emergency Med, Sch Med, Chang Won, South Korea

[2] Kyungnam Univ, Dept Phys Educ, Chang Won, South Korea

[3] Gyeongsang Natl Univ, Sch Med, Changwon Hosp, Dept Thorac & Cardiovasc Surg, Chang Won, South Korea

[4] Hallym Univ, Coll Med, Sacred Heart Hosp, Dept Emergency Med, Anyang, South Korea

[5] Kyung Hee Univ, Grad Sch, Dept Nursing, Seoul, South Korea

[6] Soonchunhyang Univ, Bucheon Hosp, Coll Med, Dept Emergency Med, Bucheon, South Korea

[7] Coll Kyungbuk, Dept Nursing Sci, Yeongju, South Korea

[8] Sungkyunkwan Univ, Samsung Changwon Hosp, Sch Med, Chang Won, South Korea

来源：

PEDIATRIC CRITICAL CARE MEDICINE | 2018年 / 19卷 / 01期

关键词：

American Heart Association guidelines; chest compression depth; pediatric arrest; BASIC LIFE-SUPPORT; CARDIOPULMONARY-RESUSCITATION; QUALITY; INFANTS; UPDATE;

D O I：

10.1097/PCC.0000000000001369

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Objective: The 2015 American Heart Association guidelines recommended pediatric rescue chest compressions of at least one-third the anteroposterior diameter of the chest, which equates to approximately 5cm. This study evaluated the appropriateness of these two types by comparing their safeties in chest compression depth simulated by CT. Design: Retrospective study with data analysis conducted from January 2005 to June 2015 Setting: Regional emergency center in South Korea. Patients: Three hundred forty-nine pediatric patients 1-9 years old who had a chest CT scan. Interventions: Simulation of chest compression depths by CT. Measurements and Main Results: Internal and external anteroposterior diameter of the chest and residual internal anteroposterior diameter after simulation were measured from CT scans. The safe cutoff levels were differently applied according to age. One-third external anteroposterior diameters were compared with an upper limit of chest compression depth recommended for adults. Primary outcomes were the rates of overcompression to evaluate safety. Overcompression was defined as a negative value of residual internal anteroposterior diameterage-specific cutoff level. Using a compression of 5-cm depth simulated by chest CT, 16% of all children (55/349) were affected by overcompression. Those 1-3 years old were affected more than those 4-9 years old (p < 0.001). Upon one-third compression of chest anteroposterior depth, only one subject (0.3%) was affected by overcompression. Rate of one-third external anteroposterior diameter greater than 6cm in children 8 and 9 years old was 16.1% and 33.3%, respectively. Conclusions: A chest compression depth of one-third anteroposterior might be more appropriate than the 5-cm depth chest compression for younger Korean children. But, one-third anteroposterior depth chest compression might induce deep compressions greater than an upper limit of compression depth for adults in older Korean children.

引用

页码：E1 / E6

页数：6

共 16 条

[1]

American Heart Association, 2000, CIRCULATION, V102, pI253

[2] Part 11: Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care [J].