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Proper compression landmark and depth for cardiopulmonary resuscitation in patients with pectus excavatum: a study using CT
  1. Ki Hyun Lee1,
  2. Kun Woo Kim2,
  3. Eun Young Kim3,
  4. Hyung Sik Kim3,
  5. Jeong Ho Kim3,
  6. Jinseong Cho4,
  7. Hyuk Jun Yang4
  1. 1School of Medicine, Gachon University, Incheon, Republic of Korea
  2. 2Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Hospital, Incheon, Republic of Korea
  3. 3Department of Radiology, Gachon University Gil Hospital, Incheon, Republic of Korea
  4. 4Department of Emergency Medicine, Gachon University Gil Hospital, Incheon, Republic of Korea
  1. Correspondence to Dr Eun Young Kim, Department of Radiology, Gachon University Gil Hospital #1198, Guwol-dong, Namdong-gu, Incheon 405-760, Republic of Korea; oneshot0229{at}gmail.com

Abstract

Objective To determine by chest CT the proper compression landmark and depth for cardiopulmonary resuscitation in patients with pectus excavatum (PE).

Methods The chest CT of 22 patients with PE (mean age=27 years; range 16–53 years, 10 male) from March 2002 to September 2011 were retrospectively evaluated as follows: length of sternum, external thickness/internal thickness (ET/IT) of the chest and the intrathoracic structures in the level of lower half (LH) of the sternum. In addition, Haller index (HI) and the degree of leftward displacement of the heart were measured. Finally, variables were also measured in an age/sex-matched control group (n=22) with no evidence of any chest wall deformity.

Results The sternal length was not different and LH of the sternum was adequate to compress left ventricle (LV) in both groups. Patients had a significant higher HI and showed a greater leftward displacement of LV centre with a mean difference of 11 mm. PE patients showed a lesser ET/IT with a mean difference of approximately 20 mm than controls (mean ET/IT=174±18/70±10 mm vs 199±23/93±15 mm, p<0.001).

Conclusions The LH of the sternum is an appropriate chest compression landmark in PE patients to compress LV, although the centre of LV shows slightly leftward displacement. Since PE patients have sunken chest, a 3–4 cm may be the proper compression depth in the patients when considering the current compression guideline in normal subjects is 5–6 cm.

  • Cardiac Arrest
  • Chest - Non Trauma
  • CT/MRI
  • Imaging, CT/MRI
  • Musculo-Skeletal, Non Traumatic Problems

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