Document Detail

The prevalence of chest compression leaning during in-hospital cardiopulmonary resuscitation.
MedLine Citation:
PMID:  21482010     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Successful resuscitation from cardiac arrest requires the delivery of high-quality chest compressions, encompassing parameters such as adequate rate, depth, and full recoil between compressions. The lack of compression recoil ("leaning" or "incomplete recoil") has been shown to adversely affect hemodynamics in experimental arrest models, but the prevalence of leaning during actual resuscitation is poorly understood. We hypothesized that leaning varies across resuscitation events, possibly due to rescuer and/or patient characteristics and may worsen over time from rescuer fatigue during continuous chest compressions.
METHODS: This was an observational clinical cohort study at one academic medical center. Data were collected from adult in-hospital and Emergency Department arrest events using monitor/defibrillators that record chest compression characteristics and provide real-time feedback.
RESULTS: We analyzed 112,569 chest compressions from 108 arrest episodes from 5/2007 to 2/2009. Leaning was present in 98/108 (91%) cases; 12% of all compressions exhibited leaning. Leaning varied widely across cases: 41/108 (38%) of arrest episodes exhibited <5% leaning yet 20/108 (19%) demonstrated >20% compression leaning. When evaluating blocks of continuous compressions (>120 s), only 4/33 (12%) had an increase in leaning over time and 29/33 (88%) showed a decrease (p<0.001).
CONCLUSIONS: Chest compression leaning was common during resuscitation care and exhibited a wide distribution, with most leaning within a subset of resuscitations. Leaning decreased over time during continuous chest compression blocks, suggesting that either leaning may not be a function of rescuer fatiguing, or that it may have been mitigated by automated feedback provided during resuscitation episodes.
David A Fried; Marion Leary; Douglas A Smith; Robert M Sutton; Dana Niles; Daniel L Herzberg; Lance B Becker; Benjamin S Abella
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-04-08
Journal Detail:
Title:  Resuscitation     Volume:  82     ISSN:  1873-1570     ISO Abbreviation:  Resuscitation     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-07-18     Completed Date:  2011-12-07     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  1019-24     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
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MeSH Terms
Audiovisual Aids
Cardiopulmonary Resuscitation / methods*
Clinical Competence
Heart Arrest / therapy*
Heart Massage*
Middle Aged
Grant Support
5K23HL083082/HL/NHLBI NIH HHS; K23 HD062629/HD/NICHD NIH HHS; K23 HD062629-02/HD/NICHD NIH HHS; K23 HL083082-01/HL/NHLBI NIH HHS
Comment In:
Resuscitation. 2011 Aug;82(8):971-2   [PMID:  21612854 ]

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