BackgroundSome researchers have reported that applying compression closer to the maximum diameter of the left ventricle (Point_max.LV) is associated with worse clinical outcomes, challenging its traditional position as optimum compression point (Point_optimum). By locating the mid‐sternum (the actual compression site) in terms of Point_max.LV and its right ventricular equivalent (Point_max.RV), we aimed to determine its optimum horizontal position associated with increased chances of return of spontaneous circulation (ROSC).MethodsA retrospective, cross‐sectional study was performed at a university hospital from 2014 to 2019 on non‐traumatic out‐of‐hospital cardiac arrest (OHCA) victims who underwent chest computed tomography. On absolute x‐axis, we designated the x‐coordinate of the mid‐sternum (x_mid‐sternum) as 0 and leftward direction as positive. Re‐defining the x‐coordinate of Point_max.RV and Point_max.LV as 0 and 1 interventricular unit (IVU), respectively, we could convert x_mid‐sternum to “−x_max.RV/(x_max.LV − x_max.RV) (IVU).” Using multiple logistic regression analysis, we investigated whether this converted x_mid‐sternum was associated with clinical outcomes, adjusting core elements of the Utstein template.ResultsAmong 887 non‐traumatic OHCA victims, 124 [64.4 ± 16.7 years, 43 women (34.7%)] were enrolled. Of these, 80 (64.5%) exhibited ROSC. X_mid‐sternum ranging from −1.71 to 0.58 (−0.36 ± 0.38) IVU was categorised into quintiles: <−0.60, −0.60 to −0.37, −0.37 to −0.22, −0.22 to −0.07 and ≥−0.07 (reference) IVU. The first quintile was positively associated with ROSC (odds ratio [95% confidence interval], 9.43 [1.44, 63.3]).ConclusionPoint_optimum might be located far rightwards to Point_max.RV, challenging the traditional assumption identifying Point_optimum as Point_max.LV.
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