Pediatric CPR quality monitoring: Analysis of thoracic anthropometric data

Abstract

Introduction Quantitative CPR quality feedback systems improve adult CPR performance. Extension to pediatric patients is desirable; however, the anthropometric measurements of the pediatric chest pertinent to guide the development of pediatric-specific CPR monitoring systems are largely unknown. Hypothesis Adult-based CPR quality monitoring and feedback systems will require pediatric-specific tailoring and adaptation. Methods Anthropometric measurements pertinent to the development of pediatric-specific CPR quality monitoring systems were obtained in 150 children ages 6 months to 8 years. Standard descriptive statistics were calculated. Absolute depth point estimates and 95% confidence intervals were calculated for the American Heart Association (AHA) chest compression depth recommendations (1/3 and 1/2 Anterior–Posterior chest depth). Percentage of subjects for which the adult minimal feedback depth of 38 mm would coach to achieve pediatric AHA target depths was determined. Results Point estimate averages for measurements pertinent to pediatric adaptation of CPR monitoring technology were: sternal width: 25.1 mm [22.0–29.2]; sternal length: 98.7 mm [95.3–102.1]; internipple distance: 120.0 mm [117.2–122.8]; chin to sternal notch: 35.3 mm [31.2–39.4]; 1/3 AP chest depth: 37.0 mm [36.1–37.8]; and 1/2 AP chest depth: 55.4 mm [54.2–56.7]. A minimal feedback depth of 38 mm would meet the minimum pediatric AHA target for depth in 55% (82/148) of subjects, and coach too deep in only 2% (3/148). Conclusion Extension of adult-based CPR quality monitoring and feedback systems will require pediatric-specific tailoring and adaptation. Future studies should examine chest compression depths in clinical settings with correlation to physiologic parameters to determine the best targets for pediatric CPR guidelines.