Hemodynamic effects of chest compression interruptions during pediatric in-hospital cardiopulmonary resuscitation

Related Experiment Video

Updated: Jan 26, 2026

A Rat Model of Ventricular Fibrillation and Resuscitation by Conventional Closed-chest Technique
09:47

A Rat Model of Ventricular Fibrillation and Resuscitation by Conventional Closed-chest Technique

Published on: April 26, 2015

16.3K

Ryan W Morgan1, William P Landis1, Alexandra Marquez1

  • 1The Children's Hospital of Philadelphia, Department of Anesthesiology and Critical Care Medicine, 3401 Civic Center Blvd, Philadelphia, PA 19104, United States.

Resuscitation
|April 5, 2019
PubMed

Insights

Brief interruptions in chest compressions during pediatric in-hospital cardiac arrest (IHCA) did not significantly alter blood pressures post-event. High-quality cardiopulmonary resuscitation (CPR) appears to mitigate negative hemodynamic impacts from short pauses.

Area of Science:

  • Pediatric Critical Care Medicine
  • Cardiovascular Physiology
  • Emergency Medicine

Background:

  • Animal studies indicate chest compression interruptions cause adverse hemodynamic effects.
  • Understanding these effects in pediatric in-hospital cardiac arrest (IHCA) is crucial for optimizing resuscitation protocols.

Purpose of the Study:

  • To evaluate the impact of chest compression interruptions on invasively measured blood pressures (BPs) during pediatric IHCA.
  • To determine if short interruptions have a lasting hemodynamic effect in this population.

Main Methods:

  • Observational study of pediatric (<18 years) IHCA with invasive arterial catheters.
  • Defined interruptions as ≥1 second between chest compressions.
  • Compared pre- and post-interruption blood pressures (diastolic and systolic) using non-parametric paired analyses.

Main Results:

  • Thirty-two IHCA events with 161 interruptions were analyzed.
  • No significant difference in blood pressures was observed before versus after interruptions.
  • Diastolic BP decreased during the first second of interruption but stabilized thereafter.

Conclusions:

  • In-hospital CPR with brief interruptions did not result in persistent detrimental hemodynamic effects.
  • High-quality CPR may buffer the negative impacts of short pauses in pediatric IHCA.
Abstract

Keywords:
Cardiac arrestCardiopulmonary resuscitationHemodynamicsPediatrics

More Related Videos

Author Spotlight: Simulating Pediatric Cardiac Surgery Using a Neonatal Piglet Model04:55

Author Spotlight: Simulating Pediatric Cardiac Surgery Using a Neonatal Piglet Model

Published on: May 26, 2023

1.3K
Ultrasonographic Assessment During Cardiopulmonary Resuscitation06:04

Ultrasonographic Assessment During Cardiopulmonary Resuscitation

Published on: October 24, 2020

7.5K

Related Concept Videos

Cardiopulmonary Resuscitation I: Adult01:21

Cardiopulmonary Resuscitation I: Adult

Cardiopulmonary resuscitation, or CPR, is a life-saving emergency procedure performed when a person's heart has stopped beating or they are no longer breathing. The foundation of CPR is Basic Life Support (BLS), which focuses on the early recognition of cardiac arrest, the immediate start of high-quality chest compressions, and the timely use of an automated external defibrillator (AED).Assessing Responsiveness and Checking the Carotid PulseWhen approaching an unresponsive person, first ensure...
673
Cardiopulmonary Resuscitation III: AED Use01:23

Cardiopulmonary Resuscitation III: AED Use

Introduction to AEDAn Automated External Defibrillator (AED) is a portable medical device that analyzes the heart's rhythm and, if necessary, delivers an electrical shock to help the heart re-establish an effective rhythm during sudden cardiac arrest (SCA). SCA occurs when the heart suddenly and unexpectedly stops beating, leading to a loss of blood flow to the brain and other vital organs. In such emergencies, time is of the essence, and using an AED, combined with Cardiopulmonary...
635
Cardiopulmonary Resuscitation IV: Pharmacological Management01:25

Cardiopulmonary Resuscitation IV: Pharmacological Management

Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
751
Cardiopulmonary Resuscitation II: ACLS Airway Management01:22

Cardiopulmonary Resuscitation II: ACLS Airway Management

Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
608
Hospitals-II00:59

Hospitals-II

Hospitals provide inpatient and outpatient services. Inpatient services provide care to patients that stay in the hospital for an extended period, ranging from days to months. Examples of inpatient services include intensive care units, hospital wards, or surgeries. Outpatient services provide care to patients who come to a hospital for a diagnostic or treatment but do not stay overnight —for example, diagnostic tests, surgical procedures, or health education.
Nurses that work in...
1.2K
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques01:30

Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques

Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway...
516