J Korean Soc Emerg Med.  2019 Oct;30(5):456-463. 10.0000/jksem.2019.30.5.456.

Is current cardiopulmonary resuscitation guideline recommending same chest compression depth between men and women appropriate?

• Kim S
• Na JU
• Lee JH
• Shin DH
• Han SK
• Choi PC

• KMID: 2470565
• DOI: http://doi.org/10.0000/jksem.2019.30.5.456

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.
METHODS
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.

Keyword

Cardiopulmonary resuscitation; X-ray computed tomography; Adult; Sex

MeSH Terms

Adult
Body Mass Index
Cardiopulmonary Resuscitation*
Emergency Service, Hospital
Female
Humans
Male
Retrospective Studies
Sternum
Thoracic Wall
Thorax*
Tomography, X-Ray Computed