Sutton Robert M, Niles Dana, Nysaether Jon, Arbogast Kristy B, Nishisaki Akira, Maltese Matthew R, Bishnoi Ram, Helfaer Mark A, Nadkarni Vinay, Donoghue Aaron
The Children's Hospital of Philadelphia, Department of Anesthesiology and Critical Care Medicine, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, United States.
Resuscitation. 2009 Oct;80(10):1137-41. doi: 10.1016/j.resuscitation.2009.06.031. Epub 2009 Jul 31.
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.
Adult-based CPR quality monitoring and feedback systems will require pediatric-specific tailoring and adaptation.
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.
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).
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.
定量心肺复苏质量反馈系统可改善成人的心肺复苏操作。将其扩展到儿科患者是有必要的；然而，与指导儿科专用心肺复苏监测系统开发相关的小儿胸部人体测量数据在很大程度上尚不清楚。
基于成人的心肺复苏质量监测和反馈系统需要针对儿科进行定制和调整。
对150名6个月至8岁的儿童进行了与开发儿科专用心肺复苏质量监测系统相关的人体测量。计算了标准描述性统计量。计算了美国心脏协会（AHA）胸外按压深度建议（前后胸深度的1/3和1/2）的绝对深度点估计值和95%置信区间。确定了成人最小反馈深度38毫米能指导达到儿科AHA目标深度的受试者百分比。
与儿科心肺复苏监测技术适配相关测量的点估计平均值为：胸骨宽度：25.1毫米[22.0 - 29.2]；胸骨长度：98.7毫米[95.3 - 102.1]；乳头间距：120.0毫米[117.2 - 122.8]；下巴至胸骨切迹：35.3毫米[31.2 - 39.4]；前后胸深度的1/3：37.0毫米[36.1 - 37.8]；前后胸深度的1/2：55.4毫米[54.2 - 56.7]。最小反馈深度38毫米将满足55%（82/148）受试者的儿科AHA最小深度目标，且指导过深的情况仅占2%（3/148）。
基于成人的心肺复苏质量监测和反馈系统的扩展需要针对儿科进行定制和调整。未来的研究应在临床环境中检查胸外按压深度与生理参数的相关性，以确定儿科心肺复苏指南的最佳目标。
