Pediatric CPR quality monitoring: analysis of thoracic anthropometric data.

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 38mm 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: 25.1mm [22.0-29.2]; sternal length: 98.7mm [95.3-102.1]; internipple distance: 120.0mm [117.2-122.8]; chin to sternal notch: 35.3mm [31.2-39.4]; 1/3 AP chest depth: 37.0mm [36.1-37.8]; and 1/2 AP chest depth: 55.4mm [54.2-56.7]. A minimal feedback depth of 38mm 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.