Retrospective Study Using Computed Tomography to Compare Sufficient Chest Compression Depth for Cardiopulmonary Resuscitation in Obese Patientsopen access
- Authors
- Lee, Heekyung; Oh, Jae hoon; Lee, Juncheol; Kang, Hyung goo; Lim, Tae Ho; Ko, Byuk Sung; Cho, Yongil; Song, Soon Young
- Issue Date
- Dec-2019
- Publisher
- WILEY
- Keywords
- body mass index; cardiopulmonary resuscitation; chest compression resuscitation; obesity
- Citation
- JOURNAL OF THE AMERICAN HEART ASSOCIATION, v.8, no.23, pp.1 - 8
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF THE AMERICAN HEART ASSOCIATION
- Volume
- 8
- Number
- 23
- Start Page
- 1
- End Page
- 8
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/146688
- DOI
- 10.1161/JAHA.119.013948
- ISSN
- 2047-9980
- Abstract
- Background
This study aimed to investigate the relationship between body mass index (BMI) and sufficient chest compression depth (CCD) in obese patients by a mathematical model.
Methods and Results
This retrospective analysis was performed with chest computed tomography images conducted between 2006 and 2018. We classified the selected individuals into underweight (<18.5), normal weight (≥18.5, <25), overweight (≥25, <30), and obese (≥30) groups according to BMI (kg/m2). We defined heart compression fraction (HCF) as and estimated under‐HCF (the value of HCF <20%), and over‐HCF (the residual depth <2 cm after simulation with chest compression depth 5 and 6 cm). We compared these outcomes between BMI groups. Of 30 342 individuals, 8856 were selected and classified into 4 BMI groups from a database. We randomly selected 100 individuals in each group and analyzed a total of 400 individuals’ cases. Higher BMI groups had a significantly decreased HCF with both 5 and 6 cm depth (P<0.001). The proportion of under‐HCF with both depths increased according to BMI group, whereas the proportion of over‐HCF decreased except for the 5 cm depth (P<0.001). The adjusted odds ratio of under‐HCF, according to BMI group after adjustment of age and sex, was 7.325 (95% CI, 3.412–15.726; P<0.001), with 5 cm and 10.517 (95% CI, 2.353–47.001; P=0.002) with 6 cm depth, respectively.
Conclusions
The recommended chest compression depth of 5 to 6 cm in the current international guideline is unlikely to provide sufficient ejection fraction during cardiopulmonary resuscitation in obese patients.
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