The impact of chest compression rates on quality of chest compressions – A manikin study

Abstract

PurposeChest compressions are often performed at a variable rate during cardiopulmonary resuscitation (CPR). The effect of compression rate on other chest compression quality variables (compression depth, duty-cycle, leaning, performance decay over time) is unknown. This randomised controlled cross-over manikin study examined the effect of different compression rates on the other chest compression quality variables. MethodsTwenty healthcare professionals performed 2min of continuous compressions on an instrumented manikin at rates of 80, 100, 120, 140 and 160min−1 in a random order. An electronic metronome was used to guide compression rate. Compression data were analysed by repeated measures ANOVA and are presented as mean (SD). Non-parametric data was analysed by Friedman test. ResultsAt faster compression rates there were significant improvements in the number of compressions delivered (160(2) at 80min−1 vs. 312(13) compressions at 160min−1, P<0.001); and compression duty-cycle (43(6)% at 80min−1 vs. 50(7)% at 160min−1, P<0.001). This was at the cost of a significant reduction in compression depth (39.5(10)mm at 80min−1 vs. 34.5(11)mm at 160min−1, P<0.001); and earlier decay in compression quality (median decay point 120s at 80min−1 vs. 40s at 160min−1, P<0.001). Additionally not all participants achieved the target rate (100% at 80min−1 vs. 70% at 160min−1). Rates above 120min−1 had the greatest impact on reducing chest compression quality. ConclusionsFor Guidelines 2005 trained rescuers, a chest compression rate of 100–120min−1 for 2min is feasible whilst maintaining adequate chest compression quality in terms of depth, duty-cycle, leaning, and decay in compression performance. Further studies are needed to assess the impact of the Guidelines 2010 recommendation for deeper and faster chest compressions.