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심폐소생술 지침에서 권장하는 가슴압박 깊이를 남녀에 동일하게 적용하는 것이 적절한가?

Is current cardiopulmonary resuscitation guideline recommending same chest compression depth between men and women appropriate?

대한응급의학회지 2019년 30권 5호 p.456 ~ 463
김상훈 ( Kim Sang-Hun ) - 강북삼성병원 응급의학과

나지웅 ( Na Ji-Ung ) - 강북삼성병원 응급의학과
이장희 ( Lee Jang-Hee ) - 강북삼성병원 응급의학과
신동혁 ( Shin Dong-Hyuk ) - 강북삼성병원 응급의학과
한상국 ( Han Sang-Kuk ) - 강북삼성병원 응급의학과
최필조 ( Choi Pil-Cho ) - 강북삼성병원 응급의학과

Abstract


Objective: This study examined whether the depth of chest compression (CC) recommended by current cardiopulmonary resuscitation guidelines is equally appropriate to both men and women.

Method: Retrospective analysis of the chest computed tomography (CT) findings was performed. The anteroposterior diameter (APD), internal compressible depth (ICD), and anterior chest wall thickness were measured at the midpoint of the lower half of the sternum. The residual diameter (RD) for simulated CC was also obtained. If the RD was less than 20 mm, it was assumed that a potential injury would occur.

Results: A total of 319 adults (173 men, 141 women), who underwent chest CT at the emergency room, were enrolled. A statistically significant difference was observed between the mean APD and ICD between men and women. The mean APD and IPD were 8 mm shorter and 9.5 mm shorter, respectively, in women than in men. When adjusted for age, height, weight, and body mass index (BMI), the differences in the value of these parameters increased even more. In simulated CC with a 60 mm depth, the predictors of RD of less than 20 mm were weighed (odds ratio [OR], 0.888; 95% confidence interval [CI], 0.826-0.954; P=0.001) and BMI (OR, 0.706; 95% CI, 0.579-0.862; P=0.001), and all cases with RD of less than 20 mm were women.

Conclusion: Chest compression of more than 60 mm may increase the potential risk of injury, particularly in women. The maximum allowable chest compression depth of less than 60 mm should be emphasized for women.

키워드

Cardiopulmonary resuscitation; X-ray computed tomography; Adult; Sex
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