Development and Evaluation of a New Chest Compression Technique for Cardiopulmonary Resuscitation in Infants

Yang, Dezhi; Kim, Kwan Ho; Oh, Je Hyeok; Son, Sunhan; Cho, Junmo; Seo, Kyung Mook

doi:10.1007/s00246-019-02135-x

Cited by 13 publications

(5 citation statements)

References 12 publications

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“…However, the CCF of 2FT was higher than the other two techniques. Previous studies reported similar results that the hand-off time of the 2TT was significantly longer than in the 2FT [16,17]. Therefore, our hypothesis predicted that the CCF of CTT would be similar to 2FT.…”

Section: Discussionsupporting

confidence: 69%

New chest compression method in infant resuscitation: Cross thumb technique

Jeon

Kim²,

Ko³

et al. 2022

PLoS ONE

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Background The two-thumb encircling technique (2TT) is superior to the two-finger technique (2FT) in infant cardiopulmonary resuscitation (CPR), but there are difficulties in providing ventilation as soon as possible. We modified the 2TT to the cross-thumb technique (CTT) to maintain good CPR performance at the same position as 2FT. We aimed to compare the quality of chest compression and brief hands-off times in 2FT, 2TT, and CTT by a single rescuer using an infant CPR manikin model. Methods This study was designed as a prospective randomized controlled simulation-based study. We used the Resusci® Baby QCPR (Laerdal Medical, Stavanger, Norway) as a simulated 3-month-old infant. Ventilation was performed by the mouth-to-mouth technique using a chest compression-to-ventilation ratio of 30:2 as a single rescuer. Data on CPR quality, such as locations, rates, depth and release of chest compressions, hands-off times, and proper ventilation, were recorded using the Resusci® Baby QCPR and SkillReporter. Also, the chest compression fraction (CCF) was automatically calculated. Results The depth of chest compression in 2FT, 2TT, and CTT were 40.0 mm (interquartile range [IQR] 39.0, 41.0), 42.0 mm (IQR 41.0, 43.0), and 42.0 mm (IQR 41.0, 43.0), respectively. The depth of chest compression in 2FT was shallower than that in the other two techniques (P<0.05). CCF in 2FT, 2TT, and CTT were 73.9% (IQR 72.2, 75.6), 71.2% (IQR 67.2, 72.2) and 71.3% (IQR 67.7, 74.1), respectively. CCF was higher in 2FT than in the other two techniques (P<0.05). Correct location in 2FT, 2TT, and CTT were 99.0% (IQR 86.0, 100.0), 100.0% (IQR 97.0, 100.0) and 100.0% (IQR 99.0, 100.0), respectively. Correct location in CTT and 2TT was higher than that in 2FT. Performing CTT, the subjective pain and fatigue score were lower than other two technique. Conclusion A new chest compression technique, CTT was better in chest compression depth compared with 2FT and may be helpful in maintaining correct chest compression location with less pain and fatigue in infant CPR.

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Section: Discussionsupporting

confidence: 69%

New chest compression method in infant resuscitation: Cross thumb technique

Jeon

Kim²,

Ko³

et al. 2022

PLoS ONE

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“…The current ScopRev identified 29 randomized crossover manikin studies, 1 observational study, and 1 randomized study comparing various finger/hand positions. 311–340…”

Section: Neonatal Life Supportmentioning

confidence: 99%

2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces

Berg,

Bray,

et al. 2023

Circulation

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The International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science. Draft Consensus on Science With Treatment Recommendations are posted online throughout the year, and this annual summary provides more concise versions of the final Consensus on Science With Treatment Recommendations from all task forces for the year. Topics addressed by systematic reviews this year include resuscitation of cardiac arrest from drowning, extracorporeal cardiopulmonary resuscitation for adults and children, calcium during cardiac arrest, double sequential defibrillation, neuroprognostication after cardiac arrest for adults and children, maintaining normal temperature after preterm birth, heart rate monitoring methods for diagnostics in neonates, detection of exhaled carbon dioxide in neonates, family presence during resuscitation of adults, and a stepwise approach to resuscitation skills training. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces list priority knowledge gaps for further research. Additional topics are addressed with scoping reviews and evidence updates.

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“…This scoping review confirmed that two-thumb-techniques resulted in improved CC depth, lower fatigue and higher proportion of correct hand placement compared with two-finger technique 36 39–41 45. Furthermore, several alternative finger and/or hand position techniques during CC have been examined 42–51 53–57 60 88. These newer CC techniques resulted in similar performance measures when compared with the two-thumb-technique.…”

Section: Discussionmentioning

confidence: 61%

“…Thirty-one studies (29 randomised crossover manikin studies34–62 and 2 clinical trials63 64) compared various finger/hand positions and the use of assistive compression devices (table 2, figure 2).…”

Section: Resultsmentioning

confidence: 99%

“…Several manikin studies examined alternative finger/hand position techniques, including (1) novel two-thumb technique,54–60 (2) vertical thumb technique,51 (3) ‘knocking finger’ technique,48 50 (4) pinched finger technique,49 (5) flexed two-finger technique46 and (6) thumb and index finger technique62 (table 2, figure 2). The ‘knocking finger’ is a novel single-hand technique with the thumb behind the middle phalanx of the index finger, which is then placed on the chest perpendicular to the sternum 48 50.…”

Section: Resultsmentioning

confidence: 99%

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Chest compressions in newborn infants: a scoping review

Ramachandran

Bruckner

Wyckoff

et al. 2022

Arch Dis Child Fetal Neonatal Ed

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AimThe International Liaison Committee on Resuscitation Neonatal Life Support Task Force undertook a scoping review of the literature to identify evidence relating to neonatal cardiopulmonary resuscitation.MethodsMEDLINE complete, EMBASE and Cochrane database of Systematic reviews were searched from inception to November 2021. Two authors screened titles and abstracts and full text reviewed. Studies were eligible for inclusion if they were peer-reviewed and assessed one of five aspects of chest compression in the newborn infant including: (1) heart rate thresholds to start chest compressions (CC), (2) compression to ventilation ratio (C:V ratio), (3) CC technique, (4) oxygen use during CC and 5) feedback devices to optimise CC.ResultsSeventy-four studies were included (n=46 simulation, n=24 animal and n=4 clinical studies); 22/74 were related to compression to ventilation ratios, 29/74 examined optimal technique to perform CC, 7/74 examined oxygen delivery and 15/74 described feedback devices during neonatal CC.ConclusionThere were very few clinical studies and mostly manikin and animal studies. The findings either reinforced or were insufficient to change previous recommendations which included to start CC if heart rate remains <60/min despite adequate ventilation, using a 3:1 C:V ratio, the two-thumb encircling technique and 100% oxygen during CC.

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Development and Evaluation of a New Chest Compression Technique for Cardiopulmonary Resuscitation in Infants

Cited by 13 publications

References 12 publications

New chest compression method in infant resuscitation: Cross thumb technique

New chest compression method in infant resuscitation: Cross thumb technique

Chest compressions in newborn infants: a scoping review

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