Chest compression metrics during infant basic life support using 15:2 and 10:2 compression-ventilation ratios: a randomized crossover simulation study.
Resuscitation plus · 2026-01-24 · Randomised trial
Abstract
INTRODUCTION: High-quality chest compressions and effective ventilation are key components of pediatric basic life support (BLS), although the optimal compression-ventilation ratio remains uncertain. This study compared cardiopulmonary resuscitation (CPR) performance metrics using two compression-to-ventilation (C:V) ratios in a simulated infant BLS model. METHODS: We conducted a randomized crossover simulation study (July 2022-June 2023) in a university-affiliated quaternary hospital. Pediatric healthcare professionals received standardized BLS training and performed paired 4-min infant CPR scenarios on a manikin without an advanced airway, using either a 15:2 or 10:2 C:V ratio, with role switching at 2 min. After a washout period, the alternate ratio was tested. The primary outcome was the proportion of chest compressions with guideline-compliant depth; secondary outcomes included additional compression and ventilation metrics. RESULTS: Ninety-two professionals participated (mean age 41.2 years; 93.5% female). The proportion of compressions with guideline-compliant depth was similar between groups (15:2: 82.0 ± 2.0% vs. 10:2: 83.5 ± 2.0%; p = 0.566), as were compression depth and rate. Full chest recoil was slightly higher with 10:2 (86.9% vs. 82.3%; p = 0.039). The 10:2 ratio resulted in more effective breaths and ventilation attempts but a lower chest compression fraction than 15:2 (64.9% vs. 73.8%; p < 0.001). CONCLUSION: In this simulation, chest compression depth did not differ between 15:2 and 10:2 CPR, while the 10:2 ratio was associated with a lower chest compression fraction.