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J Korean Soc Emerg Med > Volume 30(5); 2019 > Article
Journal of The Korean Society of Emergency Medicine 2019;30(5): 456-463.
심폐소생술 지침에서 권장하는 가슴압박 깊이를 남녀에 동일하게 적용하는 것이 적절한가?
김상훈1 , 나지웅1,2 , 이장희1 , 신동혁1,2 , 한상국1,2 , 최필조1,2
1강북삼성병원 응급의학과
2성균관대학교 의과대학 응급의학교실
Is current cardiopulmonary resuscitation guideline recommending same chest compression depth between men and women appropriate?
Sanghun Kim1 , Ji Ung Na1,2 , Jang Hee Lee1 , Dong Hyuk Shin1,2 , Sang Kuk Han1,2 , Pil Cho Choi1,2
1Department of Emergency Medicine, Kangbuk Samsung Hospital, Seoul, Korea
2Department of Emergency Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
Correspondence  Ji Ung Na ,Tel: 02-2001-1798, Fax: 02-2001-2891, Email: jiung.na@gmail.com,
Received: June 1, 2019; Revised: June 30, 2019   Accepted: July 1, 2019.  Published online: October 31, 2019.
ABSTRACT
Objective:
This study examined whether the depth of chest compression (CC) recommended by current cardiopulmonary resuscitation guidelines is equally appropriate to both men and women.
Method:
Retrospective analysis of the chest computed tomography (CT) findings was performed. The anteroposterior diameter (APD), internal compressible depth (ICD), and anterior chest wall thickness were measured at the midpoint of the lower half of the sternum. The residual diameter (RD) for simulated CC was also obtained. If the RD was less than 20 mm, it was assumed that a potential injury would occur.
Results:
A total of 319 adults (173 men, 141 women), who underwent chest CT at the emergency room, were enrolled. A statistically significant difference was observed between the mean APD and ICD between men and women. The mean APD and IPD were 8 mm shorter and 9.5 mm shorter, respectively, in women than in men. When adjusted for age, height, weight, and body mass index (BMI), the differences in the value of these parameters increased even more. In simulated CC with a 60 mm depth, the predictors of RD of less than 20 mm were weighed (odds ratio [OR], 0.888; 95% confidence interval [CI], 0.826-0.954; P=0.001) and BMI (OR, 0.706; 95% CI, 0.579-0.862; P=0.001), and all cases with RD of less than 20 mm were women.
Conclusion:
Chest compression of more than 60 mm may increase the potential risk of injury, particularly in women. The maximum allowable chest compression depth of less than 60 mm should be emphasized for women.
Key words: Cardiopulmonary resuscitation; X-ray computed tomography; Adult; Sex
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