Development and Evaluation of a New Chest Compression Technique for Cardiopulmonary Resuscitation in Infants

Pediatr Cardiol. 2019 Aug;40(6):1217-1223. doi: 10.1007/s00246-019-02135-x. Epub 2019 Jun 19.


We designed the newly developed flexed two-finger chest compression technique for cardiopulmonary resuscitation (CPR) in infants to increase the quality of chest compression by considering the advantages and disadvantages of the two-thumb encircling hand technique and conventional two-finger technique. The aim of the study is to compare the performance of the flexed two-finger technique and the currently used two-thumb technique or two-finger technique for infant CPR. A total of 42 doctors conducted 2-min single-rescuer CPR on a cardiac arrest infant model using the two-thumb technique followed, in a random order, by the two-finger technique and the flexed two-finger technique. Although the ratio of the adequate compression depth was highest in the two-thumb technique, followed by the flexed two-finger technique and two-finger technique (100% [98-100] vs. 99% [80-100] vs. 76% [42-95], respectively, P < 0.001), the hand-off time of the two-thumb technique was significantly longer than in the two-finger technique and flexed two-finger technique (31 s [28-35] vs. 29 s [27-32] vs. 29 s [26-32], respectively, P < 0.001). The number of total chest compressions of the two-thumb technique was significantly lower than in the two-finger technique and flexed two-finger technique (150 [148-159] vs. 159 [149-173] vs. 162 [150-172], respectively, P < 0.001). The newly developed chest compression technique could provide adequate compression depth without increasing the hand-off time during single-rescuer infant CPR.Trial registration: Clinical Research Information Service, KCT0002730.

Keywords: Cardiopulmonary resuscitation; Fingers; Infant; Thumb.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Cardiopulmonary Resuscitation / methods*
  • Cross-Over Studies
  • Female
  • Fingers
  • Heart Arrest / therapy
  • Heart Massage / methods*
  • Humans
  • Infant
  • Male
  • Manikins