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

¹Department of Emergency Medicine, Kangbuk Samsung Hospital, Seoul, Korea
²Department of Emergency Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea

Correspondence

Ji Ung Na ,Tel: 02-2001-1798, Fax: 02-2001-2891, Email: jiung.na@gmail.com,

Received: June 1, 2019; Revised: June 30, 2019 Accepted: July 1, 2019. Published online: October 31, 2019.

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.
Method:
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.

Key words: Cardiopulmonary resuscitation; X-ray computed tomography; Adult; Sex