Chest Compression Depth Targets in Critically Ill Infants and Children Measured With a Laser Distance Meter: Single-Center Retrospective Study From Japan, 2019-2022.

IF 4 2区 医学 Q1 CRITICAL CARE MEDICINE Pediatric Critical Care Medicine Pub Date : 2024-08-01 Epub Date: 2024-04-11 DOI:10.1097/PCC.0000000000003515
Takanari Ikeyama, Takunori Hozumi, Kazuki Kikuyama, Dana Niles, Vinay Nadkarni, Komei Ito
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Abstract

Objectives: Current resuscitation guidelines recommend target chest compression depth (CCd) of approximately 4cm for infants and 5cm for children. Previous reports based on chest CT suggest these recommended CCd targets might be too deep for younger children. Our aim was to examine measurements of anterior-posterior chest diameter (APd) with a laser distance meter and calculate CCd targets in critically ill infants and children.

Design: A retrospective descriptive study.

Setting: Single-center PICU, using data from May 2019 to May 2022.

Patients: All critically ill children admitted to PICU and under 8 years old were eligible to be included in the retrospective cohort.

Interventions: None.

Measurements and main results: The chest APd measurements using a laser distance meter are part of our usual practice on the PICU. Target CCd and the over-compression threshold CCd for each age group was calculated as 1/3 and 1/2 of APd, respectively. In 555 patients, the median (interquartile range) of the calculated target CCd for each age group was: 2.7 cm (2.5-2.9 cm), 2.9 cm (2.7-3.2 cm), 3.2 cm (3-3.5 cm), 3.4 cm (3.2-3.6 cm), 3.4 cm (3.2-3.6 cm), 3.6 cm (3.4-3.8 cm), 3.6 cm (3.4-4 cm), and 4 cm (3.5-4.2 cm), for 0, 2, 3-5, 6-8, 9-11, 12-17, 18-23, 24 to less than 60, and 60 to less than 96 months, respectively. Using guideline-recommended absolute CCd targets, 4 cm for infants and 5 cm for children, 49% of infants between 0 and 2 months, and 45.5% of children between 12 and 17 months would be over-compressed during cardiopulmonary resuscitation.

Conclusions: In our cohort, the 1/3 CCd targets calculated from APd measured by laser meter were shallower than the guideline-recommended CCd. Further studies including evaluating hemodynamics during cardiopulmonary resuscitation with these shallower CCd targets are needed.

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用激光测距仪测量重症婴幼儿的胸外按压深度目标:2019-2022年日本单中心回顾性研究。
目标:目前的复苏指南建议婴儿的目标胸外按压深度 (CCd) 约为 4 厘米,儿童约为 5 厘米。之前基于胸部 CT 的报告显示,这些推荐的 CCd 目标对于年幼儿童来说可能过深。我们的目的是使用激光测距仪检查重症婴儿和儿童的胸廓前后直径 (APd) 测量值,并计算 CCd 目标值:设计:回顾性描述性研究:单中心 PICU,使用 2019 年 5 月至 2022 年 5 月的数据:所有入住 PICU 且年龄在 8 岁以下的重症患儿均有资格纳入回顾性队列:测量和主要结果使用激光测距仪测量胸部APd是我们在PICU的常规做法之一。每个年龄组的目标 CCd 和过压阈值 CCd 分别按 APd 的 1/3 和 1/2 计算。4 厘米(3.2-3.6 厘米)、3.6 厘米(3.4-3.8 厘米)、3.6 厘米(3.4-4 厘米)和 4 厘米(3.5-4.2 厘米),分别为 0、2、3-5、6-8、9-11、12-17、18-23、24 至小于 60 和 60 至小于 96 个月。根据指南推荐的绝对CCd目标(婴儿为4厘米,儿童为5厘米),49%的0至2个月婴儿和45.5%的12至17个月儿童在心肺复苏过程中会过度受压:在我们的队列中,根据激光测量仪测量的 APd 计算出的 1/3 CCd 目标值比指南推荐的 CCd 要浅。有必要开展进一步研究,包括评估心肺复苏期间使用这些较浅 CCd 目标的血液动力学情况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Pediatric Critical Care Medicine
Pediatric Critical Care Medicine 医学-危重病医学
CiteScore
7.40
自引率
14.60%
发文量
991
审稿时长
3-8 weeks
期刊介绍: Pediatric Critical Care Medicine is written for the entire critical care team: pediatricians, neonatologists, respiratory therapists, nurses, and others who deal with pediatric patients who are critically ill or injured. International in scope, with editorial board members and contributors from around the world, the Journal includes a full range of scientific content, including clinical articles, scientific investigations, solicited reviews, and abstracts from pediatric critical care meetings. Additionally, the Journal includes abstracts of selected articles published in Chinese, French, Italian, Japanese, Portuguese, and Spanish translations - making news of advances in the field available to pediatric and neonatal intensive care practitioners worldwide.
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