1. Home>
2. Specialties>
3. General Medicine>
4. Summary and Comment

THE PREFERRED METHOD OF CPR IN NEWBORNS.

Two techniques for closed-chest cardiac massage of newborns have been recommended: two-finger compression over the mid-sternum and apposed-thumbs compression over the mid- sternum with the hands encircling the thorax. The authors describe two cases of CPR performed on preterm infants (28 and 35 weeks' gestation); in both cases the mean arterial pressure was measured through an umbilical-artery catheter. Both techniques were performed on each infant.

The mean arterial pressure was about 50 percent greater with the apposed-thumbs technique than with the two-finger technique. In addition, comparison of the arterial pressure traces revealed that the area under the curves from the two patients were 70 and 85 percent larger for the apposed- thumbs technique. The superior cardiac output with the apposed-thumbs technique may be due to an increase in the intrathoracic pressure and not to direct cardiac compression.

Thus, the widely recommended two-finger technique appears to be inferior, and the apposed-thumbs method appears preferable.

— PMM

Published in Journal Watch General Medicine April 22, 1988

Citation(s):

David R. Closed chest cardiac massage in the newborn infant. Pediatrics 1988 Apr 81 552-554.

• Medline abstract (Free)