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J Korean Soc Emerg Med > Volume 27(3); 2016 > Article
Journal of The Korean Society of Emergency Medicine 2016;27(3): 238-245.
흉부 전산화단층촬영 영상을 이용한 소아의 적정한 흉부압박 깊이 측정
진수영, 오성범, 김용오
단국대학교 의과대학 응급의학교실
Estimation of Optimal Pediatric Chest Compression Depth by Using Computed Tomography
Soo Young Jin, Seong Beom Oh, Yong Oh Kim
Department of Emergency Medicine, Dankook University College of Medicine, Cheonan, Korea
Correspondence  Seong Beom Oh ,Tel: 041) 550-7241, Fax: 041) 550-7054, Email: holytiger@hanmail.net,
Received: July 31, 2015; Revised: August 4, 2015   Accepted: August 29, 2015.  Published online: June 30, 2016.
ABSTRACT
Purpose:
The purpose of this study was to assess optimal chest compression depth for infants and children compared with adults, when the simulated compression depth was delivered according to the current guidelines.
Method:
A total of 467 consecutive chest computed tomography scans (93 of infants, 110 of children, and 264 of adults) were reviewed. The anteroposterior (AP) diameter and compressible diameter (CD) for infants and children were measured at the inter-nipple level and at the middle of the lower half of the sternum for adults. Compression ratio (CR) to CD was calculated at simulated one-fourth, onethird, and one-half AP compressions in infants and children and simulated 5-cm, 6-cm compressions in adult.
Results:
In adults, the CRs to CD at simulated 5-cm, 6-cm compression depth were 41.7±0.16%, 50.0±7.3%, respectively. In children and infants, the CRs to CD at onethird chest compression were, respectively, 55.1±2.4%, 51.8±2.4% and 82.7±3.7%, 77.7±3.6% at one-half chest compression. The CRs to CD of 4-cm compression depth in infants and 5-cm compression depth in children were 74.4±10.9%, 62.5±8.7%, respectively. The CRs to CD for children and infants were significantly higher compared with adults (p<0.001). The CR to CD of 4-cm compression depth in children was similar to that of 6-cm compression depth in adults (50.0±6.9% vs 50.0±7.3%, p=0.985).
Conclusion:
The current pediatric guideline for compression depth was too deep compared with adults. We suggest that one third of the AP chest diameter or approximately 4-cm in children and less than 4-cm in infants is more appropriate.
Key words: Chest compression, Computed tomography, Pediatrics
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