Background
Current pediatric cardiac arrest guidelines recommend depressing the chest by one‐third anterior–posterior diameter (APD), which is presumed to equate to absolute age‐specific chest compression depth targets (4 cm for infants and 5 cm for children). However, no clinical studies during pediatric cardiac arrest have validated this presumption. We aimed to study the concordance of measured one‐third APD with absolute age‐specific chest compression depth targets in a cohort of pediatric patients with cardiac arrest.
Methods and Results
This was a retrospective observational study from a multicenter, pediatric resuscitation quality collaborative (pediRES‐Q [Pediatric Resuscitation Quality Collaborative]) from October 2015 to March 2022. In‐hospital patients with cardiac arrest ≤12 years old with APD measurements recorded were included for analysis. One hundred eighty‐two patients (118 infants >28 days old to <1 year old, and 64 children 1 to 12 years old) were analyzed. The mean one‐third APD of infants was 3.2 cm (SD, 0.7 cm), which was significantly smaller than the 4 cm target depth (
P
<0.001). Seventeen percent of the infants had one‐third APD measurements within the 4 cm ±10% target range. For children, the mean one‐third APD was 4.3 cm (SD, 1.1 cm). Thirty‐nine percent of children had one‐third APD within the 5 cm ±10% range. Except for children 8 to 12 years old and overweight children, the measured mean one‐third APD of the majority of the children was significantly smaller than the 5 cm depth target (
P
<0.05).
Conclusions
There was poor concordance between measured one‐third APD and absolute age‐specific chest compression depth targets, particularly for infants. Further study is needed to validate current pediatric chest compression depth targets and evaluate the optimal chest compression depth to improve cardiac arrest outcomes.
Registration
URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02708134.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.