The influence of ventilation on chest compression force and depth during neonatal cardiopulmonary resuscitation

Ventilation during neonatal cardiopulmonary resuscitation (NCPR) may adversely affect chest compression (CC) quality (i.e., the delivery of consistent and sufficiently deep CC) since current guidelines recommend a 3:1 CC to ventilation ratio which is much higher than the 30:2 CC to ventilation ratio recommended for children and adults. In this study the influence of ventilation on CC performance during NCPR was investigated by measuring the CC depth and force during simulated unventilated and ventilated NCPR using an infant training manikin. The results obtained indicate that ventilation may exert a significant influence on CC performance during NCPR due to dynamic changes in chest properties (i.e., stiffness and damping) which likely occur due to the high frequency of inflation and deflation of the manikin lungs during NCPR at the 3:1 CC to ventilation ratio recommended by the guidelines.