Comparison of two-thumb encircling and two-finger technique during infant cardiopulmonary resuscitation with single rescuer in simulation studies: A systematic review and meta-analysis

• Published in: Medicine (Baltimore) 2019-11, Vol.98 (45), p.e17853-e17853
• Main Authors: Lee, Ji Eun, Lee, Juncheol, Oh, Jaehoon, Park, Chan Hyuk, Kang, Hyunggoo, Lim, Tae Ho, Yoo, Kyung Hun
• Format: Article
• Language: English
• Subjects: Cardiopulmonary Resuscitation - methods; Female; Fingers; Heart Arrest - therapy; Humans; Infant; Male; Manikins; Randomized Controlled Trials as Topic; Systematic Review and Meta-Analysis
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000017853

The recommended chest compression technique for a single rescuer performing infant cardiopulmonary resuscitation is the two-finger technique. For 2 rescuers, a two-thumb-encircling hands technique is recommended. Several recent studies have reported that the two-thumb-encircling hands technique is more effective for high-quality chest compression than the two-finger technique for a single rescuer performing infant cardiopulmonary resuscitation. We undertook a systematic review and meta-analysis of infant manikin studies to compare two-thumb-encircling hands technique with two-finger technique for a single rescuer. We searched MEDLINE, EMBASE, and the Cochrane Library for eligible randomized controlled trials published prior to December 2017, including cross-over design studies. The primary outcome was the mean difference in chest compression depth (mm). The secondary outcome was the mean difference in chest compression rate (counts/min). A meta-analysis was performed using Review Manager (version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014). Six studies that had reported data concerning both chest compression depth and chest compression rate were included. The two-thumb-encircling hands technique was associated with deeper chest compressions compared with two-finger technique for mean chest compression depth (mean difference, 5.50 mm; 95% confidence interval, 0.32-10.69 mm; P = .04), but no significant difference in the mean chest compression rate (mean difference, 7.89 counts/min; 95% confidence interval, to 0.99, 16.77 counts/min; P = .08) was noted. This study indicates that the two-thumb-encircling hands technique is a more appropriate technique for a single rescuer to perform high-quality chest compression in consideration of chest compression depth than the two-finger technique in infant manikin studies.