Differences in the performance of resuscitation according to the resuscitation guideline terminology during infant cardiopulmonary resuscitation: "Approximately 4 cm" versus "at least one-third the anterior-posterior diameter of the chest".

Aim: This study was conducted to investigate the effect of resuscitation guideline terminology on the performance of infant cardiopulmonary resuscitation (CPR).

Methods: A total of 40 intern or resident physicians conducted 2-min CPR with the two-finger technique (TFT) and two-thumb technique (TT) on a simulated infant cardiac arrest model with a 1-day interval. They were randomly assigned to Group A or B. The participants of Group A conducted CPR with the chest compression depth (CCD) target of "approximately 4 cm" and those of Group B conducted CPR with the CCD target of "at least one-third the anterior-posterior diameter of the chest". Single rescuer CPR was performed with a 15:2 compression to ventilation ratio on the floor.

Results: In both chest compression techniques, the average CCD of Group B was significantly deeper than that of Group A (TFT: 41.0 [range, 39.3-42.0] mm vs. 36.5 [34.0-37.9] mm, P = 0.002; TT: 42.0 [42.0-43.0] mm vs. 37.0 [35.3-38.0] mm, P < 0.001). Adequacy of CCD also showed similar results (Group B vs. A; TFT: 99% [82-100%] vs. 29% [12-58%], P = 0.001; TT: 100% [100-100%] vs. 28% [8-53%], P < 0.001).

Conclusions: Using the CCD target of "at least one-third the anterior-posterior diameter of the chest" resulted in deep and adequate chest compressions during simulated infant CPR in contrast to the CCD target of "approximately 4 cm". Therefore, changes in the terminology used in the guidelines should be considered to improve the quality of CPR.

Trial Registration: Clinical Research Information Service; cris.nih.go.kr/cris/en (Registration number: KCT0003486).