Related Experiment Video
Updated: May 10, 2026
The Perinatal Asphyxiated Lamb Model: A Model for Newborn Resuscitation
Published on: August 15, 2018
Chest compression metrics during infant basic life support using 15:2 and 10:2 compression-ventilation ratios: a
Amanda Vettoretti Nicoladeli1, Jefferson Pedro Piva1,2, Taís Sica da Rocha1,2
1Department of Pediatric Critical Care, Hospital de Clínicas de Porto Alegre, Brazil.
Insights
The 15:2 compression-to-ventilation ratio in infant cardiopulmonary resuscitation (CPR) maintained a higher chest compression fraction compared to the 10:2 ratio. However, both ratios demonstrated similar chest compression depth compliance in simulated basic life support (BLS).
Area of Science:
- Pediatric Emergency Medicine
- Cardiopulmonary Resuscitation (CPR) Science
- Medical Simulation Research
Background:
- Effective chest compressions and ventilation are crucial for pediatric basic life support (BLS).
- The optimal compression-to-ventilation (C:V) ratio for infant CPR remains an area of ongoing research.
- Previous studies highlight the importance of specific C:V ratios in simulated resuscitation scenarios.
Purpose of the Study:
- To compare cardiopulmonary resuscitation (CPR) performance metrics between two compression-to-ventilation (C:V) ratios (15:2 and 10:2).
- To evaluate the impact of different C:V ratios on chest compression depth, rate, recoil, and ventilation effectiveness in a simulated infant BLS model.
- To determine the effect of C:V ratios on chest compression fraction during infant CPR.
Main Methods:
- A randomized crossover simulation study was conducted with pediatric healthcare professionals.
- Participants performed 4-minute infant CPR scenarios on a manikin using both 15:2 and 10:2 C:V ratios.
- Primary outcome: proportion of guideline-compliant chest compressions; secondary outcomes: compression depth, rate, recoil, ventilation metrics, and chest compression fraction.
Main Results:
- Chest compression depth and rate compliance were similar between the 15:2 and 10:2 C:V ratios (82.0% vs. 83.5%).
- Full chest recoil was slightly higher with the 10:2 ratio (86.9%) compared to 15:2 (82.3%).
- The 10:2 ratio yielded more effective breaths but a significantly lower chest compression fraction (64.9%) than the 15:2 ratio (73.8%).
Conclusions:
- In simulated infant CPR, chest compression depth compliance was comparable between 15:2 and 10:2 C:V ratios.
- The 10:2 C:V ratio was associated with a reduced chest compression fraction compared to the 15:2 ratio.
- Findings suggest that while ventilation may be enhanced with 10:2, the 15:2 ratio may be preferable for maintaining continuous chest compressions in infant BLS.
Introduction:
High-quality chest compressions and effective ventilation are key components of pediatric basic life support (BLS), although the optimal compression-ventilation ratio remains uncertain. This study compared cardiopulmonary resuscitation (CPR) performance metrics using two compression-to-ventilation (C:V) ratios in a simulated infant BLS model.
Methods:
We conducted a randomized crossover simulation study (July 2022-June 2023) in a university-affiliated quaternary hospital. Pediatric healthcare professionals received standardized BLS training and performed paired 4-min infant CPR scenarios on a manikin without an advanced airway, using either a 15:2 or 10:2 C:V ratio, with role switching at 2 min. After a washout period, the alternate ratio was tested. The primary outcome was the proportion of chest compressions with guideline-compliant depth; secondary outcomes included additional compression and ventilation metrics.
Results:
Ninety-two professionals participated (mean age 41.2 years; 93.5% female). The proportion of compressions with guideline-compliant depth was similar between groups (15:2: 82.0 ± 2.0% vs. 10:2: 83.5 ± 2.0%; p = 0.566), as were compression depth and rate. Full chest recoil was slightly higher with 10:2 (86.9% vs. 82.3%; p = 0.039). The 10:2 ratio resulted in more effective breaths and ventilation attempts but a lower chest compression fraction than 15:2 (64.9% vs. 73.8%; p < 0.001).
Conclusion:
In this simulation, chest compression depth did not differ between 15:2 and 10:2 CPR, while the 10:2 ratio was associated with a lower chest compression fraction.
Related Concept Videos
01:20Assessment of Ventilation I: Respiratory Rate
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
01:29Assessment of Ventilation II: Respiratory Depth and Rhythm
Respiratory depth measures the volume of air inhaled or exhaled during a breath. It can vary from shallow to deep and typically remains consistent when a person is at rest or asleep. Occasionally, individuals will automatically inhale deeply, known as sighing, which inflates the lungs with more air than normal breathing.
To assess respiratory depth, observe the degree of chest excursion or movement:
01:19Factors Affecting Pulmonary Ventilation
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
01:16Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
01:21Cardiopulmonary Resuscitation I: Adult
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management