• William P Landis, Ryan W Morgan, Ron W Reeder, Kathryn Graham, Ashley Siems, J Wesley Diddle, Murray M Pollack, Tensing Maa, Richard P Fernandez, Andrew R Yates, Bradley Tilford, Tageldin Ahmed, Kathleen L Meert, Carleen Schneiter, Robert Bishop, Peter M Mourani, Maryam Y Naim, Stuart Friess, Candice Burns, Arushi Manga, Deborah Franzon, Sarah Tabbutt, Patrick S McQuillen, Christopher M Horvat, Matthew Bochkoris, Joseph A Carcillo, Leanna Huard, Myke Federman, Anil Sapru, Shirley Viteri, David A Hehir, Daniel A Notterman, Richard Holubkov, J Michael Dean, Vinay M Nadkarni, Robert A Berg, Heather A Wolfe, Robert M Sutton, and Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) Investigators the National Heart Lung and Blood Institute ICU-RESUScitation Project Investigators.
• Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States. Electronic address: landiswp@email.chop.edu.
• Resuscitation. 2020 Apr 1; 149: 127-133.

AimThe mathematical method used to calculate chest compression (CC) rate during cardiopulmonary resuscitation varies in the literature and across device manufacturers. The objective of this study was to determine the variability in calculated CC rates by applying four published methods to the same dataset.MethodsThis study was a secondary investigation of the first 200 pediatric cardiac arrest events with invasive arterial line waveform data in the ICU-RESUScitation Project (NCT02837497). Instantaneous CC rates were calculated during periods of uninterrupted CCs. The defined minimum interruption length affects rate calculation (e.g., if an interruption is defined as a break in CCs ≥ 2 s, the lowest possible calculated rate is 30 CCs/min). Average rates were calculated by four methods: 1) rate with an interruption defined as ≥ 1 s; 2) interruption ≥ 2 s; 3) interruption ≥ 3 s; 4) method #3 excluding top and bottom quartiles of calculated rates. American Heart Association Guideline-compliant rate was defined as 100-120 CCs/min. A clinically important change was defined as ±5 CCs/min. The percentage of events and epochs (30 s periods) that changed Guideline-compliant status was calculated.ResultsAcross calculation methods, mean CC rates (118.7-119.5/min) were similar. Comparing all methods, 14 events (7%) and 114 epochs (6%) changed Guideline-compliant status.ConclusionUsing four published methods for calculating CC rate, average rates were similar, but 7% of events changed Guideline-compliant status. These data suggest that a uniform calculation method (interruption ≥ 1 s) should be adopted to decrease variability in resuscitation science.Copyright © 2020 Elsevier B.V. All rights reserved.

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