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Appropriateness of recommended chest compression depths for cardiopulmonary resuscitation based on chest computed

Pitsucha Sanguanwit1, Nitima Saksobhavivat2, Phatthranit Phattharapornjaroen1

  • 1Department of Emergency Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchatewi, Bangkok 10400, Thailand.

Resuscitation Plus
|March 29, 2024
PubMed

Insights

Chest compression depths of 50-60 mm are effective for most adults, but individualized depths based on chest diameter are better for geriatric and obese individuals. This study evaluated compression fraction in a Thai population using CT scans.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Radiology

Background:

  • Optimizing chest compression (CC) depth is crucial for effective cardiopulmonary resuscitation (CPR).
  • Previous studies have used fixed CC depths, but individual anatomical variations may influence efficacy.
  • The heart compression fraction (HCF) is a key metric for assessing CC effectiveness.

Purpose of the Study:

  • To evaluate the appropriateness of various chest compression depths in the Thai population.
  • To compare calculated heart compression fractions (HCFs) using mathematical methods based on chest computed tomography (CT) measurements.
  • To determine optimal CC depths considering anatomical differences and patient demographics.

Main Methods:

  • A multicenter retrospective cross-sectional study included 2927 adult patients undergoing contrast-enhanced chest CT.
  • Chest parameters such as external anteroposterior diameter (EAPD) were measured.
  • HCFs were calculated for CC depths of 50 mm, 60 mm, 1/4 EAPD, and 1/3 EAPD, with subgroup analysis by sex and BMI.

Main Results:

  • Mean HCFs varied significantly with CC depth: 41.5% (50 mm), 53.5% (60 mm), 42.4% (1/4 EAPD), and 62.6% (1/3 EAPD).
  • HCF was significantly lower in males across all CC depths.
  • Older age and higher BMI correlated with lower HCF for 50 mm and 60 mm CC depths.

Conclusions:

  • CC depths of 50-60 mm are effective for general populations but less so for geriatric and obese individuals.
  • Adjusting CC depth to 1/4-1/3 of the EAPD provided better HCF outcomes.
  • Future research should focus on determining individualized CC depths based on EAPD proportion for improved CPR efficacy.
Abstract

Keywords:
Cardiopulmonary resuscitationDepth of cardiac compressionHeart compression fractionThai people

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