title: Pediatric CPR quality monitoring: analysis of thoracic anthropometric data.
abstract: BACKGROUND
  Quantitative CPR quality feedback systems improve adult CPR performance. Extension to pediatric patients is desirable; however, the anthropometric measurements of the pediatric chest pertinent to guide the development of pediatric-specific CPR monitoring systems are largely unknown.
  
  
  OBJECTIVE
  Adult-based CPR quality monitoring and feedback systems will require pediatric-specific tailoring and adaptation.
  
  
  METHODS
  Anthropometric measurements pertinent to the development of pediatric-specific CPR quality monitoring systems were obtained in 150 children ages 6 months to 8 years. Standard descriptive statistics were calculated. Absolute depth point estimates and 95% confidence intervals were calculated for the American Heart Association (AHA) chest compression depth recommendations (1/3 and 1/2 Anterior-Posterior chest depth). Percentage of subjects for which the adult minimal feedback depth of 38mm would coach to achieve pediatric AHA target depths was determined.
  
  
  RESULTS
  Point estimate averages for measurements pertinent to pediatric adaptation of CPR monitoring technology were: sternal width: 25.1mm [22.0-29.2]; sternal length: 98.7mm [95.3-102.1]; internipple distance: 120.0mm [117.2-122.8]; chin to sternal notch: 35.3mm [31.2-39.4]; 1/3 AP chest depth: 37.0mm [36.1-37.8]; and 1/2 AP chest depth: 55.4mm [54.2-56.7]. A minimal feedback depth of 38mm would meet the minimum pediatric AHA target for depth in 55% (82/148) of subjects, and coach too deep in only 2% (3/148).
  
  
  CONCLUSIONS
  Extension of adult-based CPR quality monitoring and feedback systems will require pediatric-specific tailoring and adaptation. Future studies should examine chest compression depths in clinical settings with correlation to physiologic parameters to determine the best targets for pediatric CPR guidelines.
authors: The Children's Hospital of Philadelphia, Department of Anesthesiology and Critical Care Medicine, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, United States. suttonr@email.chop.edu
authors: Robert M
authors: RM
authors: Sutton
authors: Dana
authors: D
authors: Niles
authors: Jon
authors: J
authors: Nysaether
authors: Kristy B
authors: KB
authors: Arbogast
authors: Akira
authors: A
authors: Nishisaki
authors: Matthew R
authors: MR
authors: Maltese
authors: Ram
authors: R
authors: Bishnoi
authors: Mark A
authors: MA
authors: Helfaer
authors: Vinay
authors: V
authors: Nadkarni
authors: Aaron
authors: A
authors: Donoghue
mesh_terms: D000886:Anthropometry; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D002648:Child; D002675:Child, Preschool; D019983:Guideline Adherence; D006801:Humans; D007223:Infant; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care; D013909:Thorax / Q000033:anatomy & histology*