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The CPR compression matrix: relationship among depth, recoil, and rate.
Chenguang Liu1, Peter K Kudenchuk2, Thomas Rea2
1Philips Medical, United States.
Resuscitation
|May 2, 2026
Summary
Optimal chest compression during cardiopulmonary resuscitation (CPR) involves achieving adequate depth and complete recoil. A rate of 100-104 compressions per minute best facilitates these critical elements for survival.
Area of Science:
- Emergency Medicine
- Cardiovascular Research
- Resuscitation Science
Background:
- Chest compression quality significantly impacts survival rates during cardiopulmonary resuscitation (CPR).
- Simultaneous relationships between compression depth, recoil, and rate remain underexplored.
- Understanding these dynamics is crucial for optimizing CPR techniques.
Purpose of the Study:
- To investigate the interplay between chest compression depth, recoil, and rate during CPR.
- To identify the optimal compression rate associated with achieving both adequate depth and complete recoil.
- To inform guidelines for improving CPR quality in emergency medical services (EMS).
Main Methods:
- Retrospective cohort study of adult cardiac arrest patients treated by professional rescuers (2017-2021).
- Chest compression characteristics (depth, recoil, rate) assessed using an accelerometer puck.
- Hierarchical modeling used to analyze optimal compression performance (>=50 mm depth, complete recoil) across different rate groups.
Main Results:
- Analysis included 611 patients and 27,438 30-second CPR segments.
- Optimal compression performance was highest in the 100-104 compressions/min rate group (24%).
- The likelihood of optimal performance decreased significantly at rates slower than 95 and faster than 104 compressions/min.
Conclusions:
- A compression rate of 100-104 per minute is associated with the highest probability of achieving both optimal depth and complete recoil.
- This rate range appears to be a key target for improving CPR quality.
- Findings can guide rescuer training and performance feedback.
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