title: Application of an anatomically-detailed finite element thorax model to investigate pediatric cardiopulmonary resuscitation techniques on hard bed.
abstract: OBJECTIVE
  Improved Cardiopulmonary Resuscitation (CPR) approaches will largely benefit the children in need. The constant peak displacement and constant peak force loading methods were analyzed on hard bed for pediatric CPR by an anatomically-detailed 10 year-old (YO) child thorax finite element (FE) model. The chest compression and rib injury risk were studied for children with various levels of thorax stiffness.
  
  
  METHODS
  We created three thorax models with different chest stiffness. Simulated CPR׳s in the above two conditions were performed. Three different compression rates were considered under the constant peak displacement condition. The model-calculated deflections and forces were analyzed. The rib maximum principle strains (MPS׳s) were used to predict the potential risk of rib injury.
  
  
  RESULTS
  Under the constant peak force condition, the chest deflection ranged from 34.2 to 42.2mm. The highest rib MPS was 0.75%, predicted by the compliant thorax model. Under the normal constant peak displacement condition, the highest rib MPS was 0.52%, predicted by the compliant thorax model. The compression rate did not affect the highest rib MPS.
  
  
  CONCLUSIONS
  Results revealed that the thoracic stiffness had great effects on the quality of CPR. To maintain CPR quality for various children, the constant peak displacement technique is recommended when the CPR is performed on the hard bed. Furthermore, the outcome of CPR in terms of rib strains and total work are not sensitive to the compression rate. The FE model-predicted high strains were in the ribs, which have been found to be vulnerable to CPR in the literature.
authors.affiliation: The State Key Laboratory of Advanced Design and Manufacturing for Vehicle Body, Hunan University, Changsha, Hunan, China.
authors.forename: Binhui
authors.initials: B
authors.lastname: Jiang
authors.affiliation: Bioengineering Center, Wayne State University, Detroit, MI, USA.
authors.forename: Haojie
authors.initials: H
authors.lastname: Mao
authors.affiliation: The State Key Laboratory of Advanced Design and Manufacturing for Vehicle Body, Hunan University, Changsha, Hunan, China.
authors.forename: Libo
authors.initials: L
authors.lastname: Cao
authors.affiliation: Bioengineering Center, Wayne State University, Detroit, MI, USA. Electronic address: aa0007@wayne.edu.
authors.forename: King H
authors.initials: KH
authors.lastname: Yang
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D002648:Child; D020342:Finite Element Analysis; D006801:Humans; D008953:Models, Anatomic; D013909:Thorax / Q000503:physiopathology*
keywords: Cardiopulmonary resuscitation; Chest deflection; Compression rate; Finite element model; Hard bed; Rib injury