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Resuscitators who compared four simulated infant cardiopulmonary resuscitation methods favoured the three-to-one
Anne Marthe Boldingh1,2, Anne Lee Solevåg1, Elisabeth Aasen1
1Department of Paediatric and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway.
Insights
The 3:1 compression-to-ventilation (C:V) method improved cardiopulmonary resuscitation (CPR) quality in simulated infant scenarios. This method offered better coordination between healthcare professionals compared to other C:V ratios and continuous chest compressions.
Area of Science:
- Pediatrics
- Emergency Medicine
- Cardiopulmonary Resuscitation
Background:
- Suboptimal cardiopulmonary resuscitation (CPR) is linked to adverse patient outcomes.
- International guidelines emphasize optimizing compression and ventilation with minimal interruptions during CPR.
- Investigating different compression-to-ventilation (C:V) ratios is crucial for improving resuscitation effectiveness.
Purpose of the Study:
- To compare the quality of chest compressions and ventilation mechanics using four simulated infant CPR methods.
- To assess resuscitator preferences for different C:V ratios.
- To identify the most effective C:V method for infant resuscitation.
Main Methods:
- A crossover manikin study involving 42 pairs of healthcare professionals.
- Evaluation of four CPR methods: 3:1, 9:3, and 15:2 C:V ratios, and continuous chest compressions with asynchronous ventilations (CCaV-120).
- Measurement of chest compression depth, ventilation mechanics, and resuscitator coordination.
Main Results:
- The 3:1 and 9:3 C:V methods yielded comparable chest compression and ventilation mechanics.
- The 15:2 C:V method resulted in fewer ventilations and lower minute volumes.
- The CCaV-120 method was less effective than 3:1 C:V, showing reduced compression depth, fewer compressions and ventilations per minute, and lower minute volume.
Conclusions:
- The 3:1 C:V method was favored in simulated infant CPR due to superior effectiveness and coordination.
- Multidisciplinary participants found the 3:1 C:V method provided the best coordination.
- This study supports the 3:1 C:V ratio as an optimal strategy for infant resuscitation.
Aim:
Suboptimal cardiopulmonary resuscitation (CPR) is associated with a poor outcome, and international guidelines state that resuscitators should optimise compression and ventilation techniques with as few interruptions as possible. We investigated compression and ventilation quality during simulated CPR with four compression-to-ventilation (C:V) methods.
Methods:
In this crossover manikin study, 42 pairs of doctors, nurses, midwives and sixth-year medical students from two Norwegian hospitals provided two-minute resuscitation using the 3:1, 9:3 and 15:2 C:V methods and continuous chest compressions at 120 per minute with asynchronous ventilations (CCaV-120). We measured chest compression, ventilation mechanics and the resuscitators' preferences.
Results:
C:V methods 3:1 and 9:3 provided comparable chest compressions and ventilation mechanics, whereas 15:2 produced fewer ventilations and lower minute volumes. The CCaV-120 method was significantly less effective than the 3:1 C:V ratio method: the chest compression depth was 1.9 mm lower, there were 25 fewer chest compressions and 21 fewer ventilations per minute, and the minute volume was 69 mL lower. The 3:1 C:V method also provided better coordination between resuscitators.
Conclusion:
Our comparison of four simulated infant cardiopulmonary resuscitation methods favoured the 3:1 C:V method, and the multidisciplinary group of participants felt it offered the best level of coordination between resuscitators.
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