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Excessive chest compression rate is associated with insufficient compression depth in out-of-hospital cardic arrest

Koenraad Monsieurs UGent, Melissa De Regge UGent, Kristof Vansteelandt, Jeroen Desmet, Emmanuel Annaert UGent, SABINE LEMOYNE UGent, Alain Kalmar UGent and Paul Calle UGent (2012) ACTA CLINICA BELGICA. 67.
abstract
Introduction : In the 2010 Guidelines on Cardiopulmonary Resuscitation the relationship between compression rate and depth is considered to be a knowledge gap. In order to characterise this relationship, we performed an observational study in out-of-hospital cardiac arrest patients. We hypothesized that faster chest compressions are associated with decreased depth. Materials and methods : In patients undergoing out-of-hospital cardiopulmonary resuscitation according to 2005 Guidelines, chest compression rate and depth were recorded using an accelerometer on a Zoll E-series monitor-defibrillator providing feedback for compressions <4 cm deep and <80/min. Compression depth was compared for rates <80/min, 80-120/min and >120/min. Multilevel models with repeated measurements of compression depth and rate, nested within patients, were used with depth as a continuous and as a categorical variable. A difference in depth ≥0.5 cm was considered clinically significant. Results are reported as means and standard error. Results and discussion : One hundred and thirty-three consecutive patients were analysed (213409 compressions). Of all compressions 2% were <80/min, 62% between 80-120/min and 36% >120/min, 36 % were <4 cm deep, 45% between 4 and 5 cm, 19% >5cm. Compression depth for rates 80-120/min was 4.6 (±0.003) cm compared to 3.9 (±0.003) cm for compressions >120/min (mean difference 0.7 cm, P<0.001). In 77 out of 133 (58 %) patients a statistically significant lower depth was observed for rates >120/min compared to rates 80-120/min, in 40 out of 133 (30%) this difference was also clinically significant. Moreover, the multilevel models showed that the deepest compression occurred at a rate of 64/min, with progressively lower depths at higher rates. Age and sex of the patient had no additional effect on depth. Conclusions : This study showed an association between higher compression rates and lower compression depths. To avoid superficial compressions, feedback devices should alert rescuers when compression rates become excessively high.
Please use this url to cite or link to this publication:
author
organization
year
type
conference
publication status
published
subject
keyword
cardiac arrest, compression rate, compression depth
in
ACTA CLINICA BELGICA
Acta Clin. Belg.
volume
67
conference name
2012 Symposium of the Belgian Society for Disaster and Emergency Medicine (BESEDIM)
conference location
Brussels, Belgium
conference start
2012-01-14
conference end
2012-01-14
JCR category
MEDICINE, GENERAL & INTERNAL
JCR impact factor
0.589 (2012)
JCR rank
107/149 (2012)
JCR quartile
3 (2012)
ISSN
0001-5512
language
English
UGent publication?
yes
classification
C3
id
1988708
handle
http://hdl.handle.net/1854/LU-1988708
date created
2012-01-17 09:35:14
date last changed
2012-09-05 09:16:58
@inproceedings{1988708,
  abstract     = {Introduction : In the 2010 Guidelines on Cardiopulmonary Resuscitation the relationship between compression rate and depth is considered to be a knowledge gap.  In order to characterise this relationship, we performed an observational study in out-of-hospital cardiac arrest patients. We hypothesized that faster chest compressions are associated with decreased depth.
Materials and methods : In patients undergoing out-of-hospital cardiopulmonary resuscitation according to 2005 Guidelines, chest compression rate and depth were recorded using an accelerometer on a Zoll E-series monitor-defibrillator providing feedback for compressions {\textlangle}4 cm deep and {\textlangle}80/min. Compression depth was compared for rates {\textlangle}80/min, 80-120/min and {\textrangle}120/min. Multilevel models with repeated measurements of compression depth and rate, nested within patients, were used with depth as a continuous and as a categorical variable. A difference in depth \ensuremath{\geq}0.5 cm was considered clinically significant. Results are reported as means and standard error.
Results and discussion : One hundred and thirty-three consecutive patients were analysed (213409 compressions). Of all compressions 2\% were {\textlangle}80/min, 62\% between 80-120/min and 36\% {\textrangle}120/min, 36 \% were {\textlangle}4 cm deep, 45\% between 4 and 5 cm, 19\% {\textrangle}5cm. Compression depth for rates 80-120/min was 4.6 ({\textpm}0.003) cm compared to 3.9 ({\textpm}0.003) cm for compressions {\textrangle}120/min (mean difference 0.7 cm, P{\textlangle}0.001). In 77 out of 133 (58 \%) patients a statistically significant lower depth was observed for rates {\textrangle}120/min compared to rates 80-120/min, in 40 out of 133 (30\%) this difference was also clinically significant. Moreover, the multilevel models showed that the deepest compression occurred at a rate of 64/min, with progressively lower depths at higher rates. Age and sex of the patient had no additional effect on depth.
Conclusions : This study showed an association between higher compression rates and lower compression depths. To avoid superficial compressions, feedback devices should alert rescuers when compression rates become excessively high.},
  author       = {Monsieurs, Koenraad and De Regge, Melissa and Vansteelandt, Kristof and Desmet, Jeroen  and Annaert, Emmanuel and LEMOYNE, SABINE and Kalmar, Alain and Calle, Paul},
  booktitle    = {ACTA CLINICA BELGICA},
  issn         = {0001-5512},
  keyword      = {cardiac arrest,compression rate,compression depth},
  language     = {eng},
  location     = {Brussels, Belgium},
  title        = {Excessive chest compression rate is associated with insufficient compression depth in out-of-hospital cardic arrest},
  volume       = {67},
  year         = {2012},
}

Chicago
Monsieurs, Koenraad, Melissa De Regge, Kristof Vansteelandt, Jeroen Desmet, Emmanuel Annaert, SABINE LEMOYNE, Alain Kalmar, and Paul Calle. 2012. “Excessive Chest Compression Rate Is Associated with Insufficient Compression Depth in Out-of-hospital Cardic Arrest.” In Acta Clinica Belgica. Vol. 67.
APA
Monsieurs, K., De Regge, M., Vansteelandt, K., Desmet, J., Annaert, E., LEMOYNE, S., Kalmar, A., et al. (2012). Excessive chest compression rate is associated with insufficient compression depth in out-of-hospital cardic arrest. ACTA CLINICA BELGICA (Vol. 67). Presented at the 2012 Symposium of the Belgian Society for Disaster and Emergency Medicine (BESEDIM).
Vancouver
1.
Monsieurs K, De Regge M, Vansteelandt K, Desmet J, Annaert E, LEMOYNE S, et al. Excessive chest compression rate is associated with insufficient compression depth in out-of-hospital cardic arrest. ACTA CLINICA BELGICA. 2012.
MLA
Monsieurs, Koenraad, Melissa De Regge, Kristof Vansteelandt, et al. “Excessive Chest Compression Rate Is Associated with Insufficient Compression Depth in Out-of-hospital Cardic Arrest.” Acta Clinica Belgica. Vol. 67. 2012. Print.