Comparison of optimal point on the sternum for chest compression between obese and normal weight individuals with respect to body mass index, using computer tomography: A retrospective study. (July 2018)

• Record Type: Journal Article
• Authors: Lee, Juncheol; Oh, Jaehoon; Lim, Tae Ho; Kang, Hyunggoo; Park, Jung Hwan; Song, Soon Young; Shin, Ga Hye; Song, Yeongtak
• Is Part Of: Resuscitation. Volume 128(2018)
• Page Start: 1
• Page End: 5
• Publication Date: 2018-07
• Subjects: CPR cardiopulmonary resuscitation -- ILCOR International Liaison Committee on Resuscitation -- BMI body mass index -- CT computed tomography -- PACS picture archiving and communication system -- S sternal length -- OPLV a point at which is maximal left ventricular diameter in relationship to the sternum -- %S OPLV a percentage of the distance from the distal point of sternum to OPLV in the whole length of that sternum -- OPG Optimal point on the sternum recommended by Guidelines 2015 -- ANCOVA analysis of covariance -- SD standard deviation -- OHCA out of hospital cardiac arrest -- AHA American Heart Association; Basic life support -- Body mass index -- Cardiopulmonary resuscitation -- Chest compression -- Proper hand position; Resuscitation -- Periodicals; Resuscitation -- Periodicals; Réanimation -- Périodiques; Electronic journals; 616.025
• DOI: 10.1016/j.resuscitation.2018.04.023
• Languages: English
• ISSNs: 0300-9572

Abstract

Abstract: Background: Abdominal fatty tissue deposition in obese individuals could alter the proper hand position for chest compression during cardiopulmonary resuscitation, similar to that in pregnant women. This study aimed to identify the difference in body mass index between obese and normal weight individuals by measuring the optimal point of maximal left ventricular diameter (OP LV ), using computed tomography (CT). Methods: We performed a retrospective analysis of chest CT scans between January 2012 and August 2016 and measured the sternal length and OP LV and estimated the ratio of OP LV to that individual sternal length. We also investigated whether OP LV was within the clinically relevant range of 20 mm to the position advised by the Guidelines 2015. We compared these outcomes between the two groups. Results: We randomly selected and analysed 50 of 7229 normal weight and 50 of 394 obese individuals from a database. The mean ± standard deviation of the ratio of OP LV was 22.0 ± 5.7% and 14.8 ± 6.6% of the sternal length, as measured from its most caudal point, respectively, for the obese and normal weight groups (p < 0.001). Both are more caudal than at the middle point of "the lower half of the sternum" as currently recommended. Notably, 96% of the OP LV in the obese group was within ±20 mm of the guideline point versus 52% for normal weight group. Conclusion: OP LV on the sternum in obese individuals was more cranial than that in normal weight individuals. The optimal point for chest compression in obese individuals could be slightly more cranial than that in the others.