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Updated: Aug 11, 2025
Ultrasonographic Assessment During Cardiopulmonary Resuscitation
Published on: October 24, 2020
Using computed tomography to evaluate proper chest compression depth for cardiopulmonary resuscitation in Thai
Pongsakorn Atiksawedparit1, Thanaporn Sathapornthanasin2, Phanorn Chalermdamrichai2
1Faculty of Medicine Ramathibodi Hospital, Chakri Naruebodindra Medical Institute, Mahidol University, Bangkok, Thailand.
Insights
Cardiopulmonary resuscitation (CPR) effectiveness depends on chest compression depth. This study found that recommended CPR depths of 5-6 cm are likely sufficient for the Thai population, with variations noted between genders and BMI groups.
Area of Science:
- Medical Imaging and Diagnostics
- Cardiology and Resuscitation Science
- Biomedical Engineering
Background:
- Cardiopulmonary resuscitation (CPR) effectiveness is critically dependent on achieving adequate chest compression depth and rate.
- The American Heart Association recommends a chest compression (CC) depth of 5-6 cm for effective cardiac output during cardiac arrest.
- Existing research indicates potential differences in body morphology between Caucasian and Asian populations, necessitating population-specific CPR guidelines.
Purpose of the Study:
- To determine the heart compression fraction (HCF) in the Thai population.
- To assess the adequacy of recommended chest compression depths (5-6 cm) for effective CPR in Thai individuals.
- To investigate the influence of demographic factors like gender and body mass index (BMI) on HCF.
Main Methods:
- Retrospective review of contrast-enhanced computed tomography (CT) scans of the chest from 306 subjects.
- Measurement of chest and heart parameters from CT scans by two independent radiologists.
- Calculation of heart compression fraction (HCF) using a mathematical model based on CT-derived measurements.
Main Results:
- Mean HCF proportions corresponding to 50 mm and 60 mm CC depths were 38.3% and 50%, respectively.
- Significant differences in HCF were observed between males and females for both 50 mm and 60 mm compression depths (P<0.001).
- Higher BMI groups showed a significant decrease in HCF, indicating reduced compression effectiveness with increased body mass.
Conclusions:
- The study validates that CPR depths of 5 cm and 6 cm generate HCF proportions of approximately 38% and 50%, respectively, in the Thai population.
- Gender and BMI significantly impact HCF, suggesting potential need for tailored CPR approaches.
- The recommended 5-6 cm CC depth is likely adequate for effective CPR in the general Thai population.
Introduction:
The effectiveness of cardiopulmonary resuscitation is determined by appropriate chest compression depth and rate. The American Heart Association recommended CC depth at 5-6 cm to indicate proper cardiac output during cardiac arrest. However, many studies showed the differences in the body builds between Caucasians and Asians. Therefore, this study aimed to determine heart compression fraction (HCF) in the Thai population by using contrast-enhanced computed tomography (CT) scan of the chest and a mathematical model.
Materials And Methods:
Consecutive contrast-enhanced CT scans of the chest performed at Ramathibodi Hospital were retrospectively reviewed from January to March 2018 by two independent radiologists. Patients' characteristics, including gender, age, weight, height, and pre-existing diseases, were recorded, and the chest parameters were measured from a CT scan. The heart compression fraction (HCF) was subsequently calculated.
Results:
Of 306 subjects, there were 139 (45.4%) males, 148 (47.4%) lung diseases and 10 (3.3%) heart diseases. Mean age and BMI were 60.4 years old and 23.8 kg/m2, respectively. Chest diameter, heart diameter, and non-cardiac soft tissue were significantly smaller in females compared to males. Mean (SD) HCF proportional with 50 mm and 60 mm depth were 38.3% (13.3%) and 50% (14.3%), respectively. There were significant differences of HCF proportional by 50 mm and 60 mm depth between men and women (33.2% vs 42.6% and 44% vs 54.9%, respectively (P<0.001)). In addition, a decrease in HCF was significantly observed among higher BMI groups.
Conclusion:
The CT scan and mathematical model showed that 38% and 50% HCF proportions were generated by 50 mm and 60 mm CC depth. HCF proportions were significantly different between genders and among BMI groups. The recommended depth of 5-6 cm is likely to provide sufficient CC depth in the population of Thailand.
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