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Estimation of anatomical structures underneath the chest compression landmarks in children by using computed tomography

Authors
 Yoo Seok Park  ;  Incheol Park  ;  Young Jin Kim  ;  Tae Nyoung Chung  ;  Sun Wook Kim  ;  Min Joung Kim  ;  Sung Phil Chung  ;  Hahn Shick Lee 
Citation
 Resuscitation, Vol.82(8) : 1030-1035, 2011 
Journal Title
 Resuscitation 
ISSN
 0300-9572 
Issue Date
2011
Abstract
OBJECTIVE: There has been little investigation on the appropriateness of the hand position suggested by various guidelines in paediatric cardiopulmonary resuscitation (CPR). We aimed to identify anatomical structures underneath the chest compression landmarks and tried to find the proper hand position using computed tomography (CT) images for more effective paediatric CPR. PATIENTS AND METHODS: This study included a total of 181 paediatric patients who were admitted to Severance Hospital and underwent CTs of chest. We studied structures located under the inter-nipple line and under the lower third of the sternum. The distances from the xiphoid process to the level of the left ventricular outflow tract (LVOT) were measured to find the ceiling on the proper hand position. RESULTS: The LVOT (42.0%) and the root of the aorta (21.5%) were more frequently located than the left ventricle under the inter-nipple line, and the liver was located under the lower third of the sternum in a significant number of patients (28.7%). The LVOT was placed 6.8±13.9 mm below the nipple level, but there was no significant difference in the distance from the nipple level to the LVOT among the age groups (p=0.517). CONCLUSIONS: The hand position at the inter-nipple line might be too high and that at the lower third of the sternum might be too low as it can compress the liver. Further studies are needed to find the proper hand position for more effective chest compression during paediatric CPR.
Full Text
http://www.sciencedirect.com/science/article/pii/S0300957210010695
DOI
10.1016/j.resuscitation.2010.11.004
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min Joung(김민정) ORCID logo https://orcid.org/0000-0003-1634-5209
Kim, Sun Wook(김선욱)
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Park, Yoo Seok(박유석) ORCID logo https://orcid.org/0000-0003-1543-4664
Park, In Cheol(박인철) ORCID logo https://orcid.org/0000-0001-7033-766X
Lee, Hahn Shick(이한식)
Chung, Sung Pil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
Chung, Tae Nyoung(정태녕)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/93692
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