J Korean Soc Emerg Med.  2021 Feb;32(1):5-10.

Analysis of proper chest compression position according to abdominal distension using multi-detector computed tomography

• Lee JH
• Koh CY
• Cho HY

Abstract

Objective
The purpose of this study was to analyze the effect of abdominal distension on proper chest compression position selection during the use of multi-detector computed tomography (MDCT).
Methods
Fifty-eight patients who underwent thoraco-abdominal MDCT for the diagnosis of aortic dissection from January 2013 to August 2018 were included in the study. Abdominal distension was defined as a condition in which the area around the navel in the supine position was higher than the lower half of the sternum. The left ventricle maximal diameter (LVMD) level was scored based on the vertebral body using MDCT. The distance from the end of the sternum (S_e), the middle of the lower half of the sternum (S_m), and the upper edge of the liver (L_u) to the LVMD were measured and analyzed.
Results
The LVMD level was significantly higher in the abdominal distension group than in the non-abdominal distension group (1.74±1.39 vs. 2.77±1.33, P=0.007). The difference was about 1/2 of the height of a vertebral body, i.e. 1.2 cm. In the abdominal distension group, L_u was higher (19.6±18.0 vs. 29.2±13.1, P=0.034) and the distance from LVMD to S_m was shorter than in the non-abdominal distension group (36.3±17.5 vs. 45.8±11.5, P=0.027).
Conclusion
Abdominal distension alters the position of the heart through the elevation of the diaphragm. Therefore, when performing chest compressions in patients with cardiac arrest, it is necessary to select a chest compression location based on the presence or absence of abdominal distension.

Keyword

Cardiopulmonary resuscitation; Tomography; Sternum; Abdomen