Evaluation of a newly developed infant chest compression technique

Abstract

Background:Providing adequate chest compression is essential during infant cardio-pulmonary-resuscitation (CPR) but was reported to be performed poor. The “new 2-thumb technique” (nTTT), which consists in using 2 thumbs directed at the angle of 90° to the chest while closing the fingers of both hands in a fist, was recently introduced. Therefore, the aim of this study was to compare 3 chest compression techniques, namely, the 2-finger-technique (TFT), the 2-thumb-technique (TTHT), and the nTTT in an randomized infant-CPR manikin setting.Methods:A total of 73 paramedics with at least 1 year of clinical experience performed 3 CPR settings with a chest compression:ventilation ratio of 15:2, according to current guidelines. Chest compression was performed with 1 out of the 3 chest compression techniques in a randomized sequence. Chest compression rate and depth, chest decompression, and adequate ventilation after chest compression served as outcome parameters.Results:The chest compression depth was 29 (IQR, 28–29) mm in the TFT group, 42 (40–43) mm in the TTHT group, and 40 (39–40) mm in the nTTT group (TFT vs TTHT, P < 0.001; TFT vs nTTT, P < 0.001; TTHT vs nTTT, P < 0.01). The median compression rate with TFT, TTHT, and nTTT varied and amounted to 136 (IQR, 133–144) min–1 versus 117 (115–121) min–1 versus 111 (109–113) min–1. There was a statistically significant difference in the compression rate between TFT and TTHT (P < 0.001), TFT and nTTT (P < 0.001), as well as TTHT and nTTT (P < 0.001). Incorrect decompressions after CC were significantly increased in the TTHT group compared with the TFT (P < 0.001) and the nTTT (P < 0.001) group.Conclusions:The nTTT provides adequate chest compression depth and rate and was associated with adequate chest decompression and possibility to adequately ventilate the infant manikin. Further clinical studies are necessary to confirm these initial findings.

Comparison of two infant chest compression techniques during simulated newborn cardiopulmonary resuscitation performed by a single rescuer: A randomized, crossover multicenter trial

“…In both analyzed CC techniques, full chest relaxation was obtained in a very high percentage of CCs (97% for TFT and 94% for NTTT; the difference was not statistically significant). In other studies it was emphasized that one of the main advantages of TFT was a high percentage of full chest relaxation, which turned out significantly better with the use of TTHT [20].…”

“…Previous studies have proven advantages of NTTT in infant, neonatal, and newborn resuscitation in various simulation settings, including 2-min vs. 10-min CCs, different manikin models, and diverse study methodology [20][21][22][23][24]. In contrast to previous research in newborn simulation settings [21,35], in this study the standard CC was used: the 3:1 ventilation ratio for newborn resuscitation [4], allowing to achieve approximately 90 CCs per minute.…”

“…The study is a continuation of the research conducted by the authors on improving the quality of CCs during pediatric resuscitation [18,[20][21][22][23][24] in various study groups and settings.…”

“…The novel technique has been investigated in several studies in different age groups and study participants as well as in different settings, with the consideration of the resuscitation technique, CC and ventilation ratio, and the time of resuscitation efforts [18,[20][21][22]. The results suggest that NTTT provides several advantages as compared with standard newborn resuscitation techniques, e.g.…”

The effect of chest compression frequency on the quality of resuscitation by lifeguards. A prospective randomized crossover multicenter simulation trial

“…There are several limitations in the present study. The study was performed using manikin models with all the limitations for this type of research, however in resuscitation trials, the use of simulators is standard procedure and enables equal and repetitive conditions for all participants [40][41][42][43]. The second limitation is the study group.…”