Abstract
Out-of-hospital infant cardiopulmonary arrest is a fatal and uncommon event. High mortality rates and poor neurological outcomes may be improved by early cardiopulmonary resuscitation (CPR). The ongoing debate over two different infant CPR techniques, the two-thumb (TT) and the two-finger (TF) technique, has remained, especially in terms of the adequate compression depth, compression rate, and hands-off time. In this article, we searched three major databases, PubMed, EMBASE (Excerpta Medica database), and CENTRAL (Cochrane Central Register of Controlled Trials), for randomized control trials which compared the outcomes of interest between the TT and TF techniques in infant CPR. The results showed that the TT technique was associated with higher proportion of adequate compression depth (Mean difference (MD): 19.99%; 95%, Confidence interval (CI): 9.77 to 30.22; p < 0.01) than the TF technique. There was no significant difference in compression rate and hands-off time. In our conclusion, the TT technique is better in terms of adequate compression depth than the TF technique, without significant differences in compression rate and hands-off time.
Highlights
Out-of-hospital infant cardiopulmonary arrest is a fatal and uncommon event with a high mortality rate and poor neurological outcome [1,2,3]
There is a concern that the two-thumb encircling (TT) technique may elicit this advantage at the cost of longer time in switching from compression to ventilation during cardiopulmonary resuscitation (CPR), especially in a single rescuer
The results revealed that all the pooled estimates after omitting one study at a time still lie within the 95% confidence interval of the overall estimate in hands-off time
Summary
Out-of-hospital infant cardiopulmonary arrest is a fatal and uncommon event with a high mortality rate and poor neurological outcome [1,2,3]. Cardiopulmonary resuscitation with effective chest compressions and rescue ventilation may improve the clinical outcome. Current guidelines for infant cardiopulmonary resuscitation (CPR). Recommend two chest compression techniques: the two-finger (TF) for a single rescuer and the two-thumb encircling (TT) chest compression for two or more rescuers [4,5]. There is a concern that the TT technique may elicit this advantage at the cost of longer time in switching from compression to ventilation during CPR, especially in a single rescuer. There is a lack of strong evidence to confirm this concern, the TT technique is currently not recommended for a lone rescuer. Public Health 2020, 17, 5214; doi:10.3390/ijerph17145214 www.mdpi.com/journal/ijerph
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