Research Information System
Disaster and Emergency Medicine Journal, vol.10, no.2, pp.64-73, 2025 (Scopus)
INRODUCTION: Pediatric cardiac arrest, though less common than in adults, remains a critical medical emergency with significant implications for mortality and morbidity. High-quality chest compressions, defined by adequate depth, appropriate rate, full chest recoil, and minimal interruptions, are fundamental to improving survival and neurological outcomes. Despite current guidelines recommending one-hand (OH) or two-hand (TH) techniques based on the child’s size and the rescuer’s capabilities, evidence comparing these methods remains limited and inconclusive. MATERIAL AND METHODS: This systematic review and meta-analysis followed PRISMA guidelines and included randomized controlled trials (RCTs) and observational studies comparing OH and TH chest compression techniques during pediatric cardiopulmonary resuscitation (CPR) in simulation-based settings. Comprehensive database searches and rigorous eligibility criteria were applied to ensure the inclusion of high-quality studies reporting outcomes such as compression depth, rate, and recoil. RESULTS: The analysis showed no significant difference in mean compression rates between OH and TH techniques (126.92 ± 21.08 vs 123.97 ± 19.58; p = 0.89), but OH achieved a higher proportion of adequate rates (89.84% vs 81.46%; p = 0.006). TH provided greater compression depth (39.53 mm vs 34.16 mm; p < 0.001), while recoil rates were comparable (p = 0.36). Hands-off time was shorter with OH (7.83 vs 8.37 seconds; p = 0.02), but TH generated higher compression pressure (91.61 mmHg vs 79.59 mmHg; p < 0.001). Rescuer heart rate changes were similar, though OH was reported as more subjectively difficult (p < 0.001). CONCLUSIONS: The analysis indicates that the TH chest compression technique outperforms the OH method in compression depth, rate consistency, fatigue reduction, and force distribution. These results support the TH technique as a preferred approach in pediatric CPR, especially for older children or during prolonged resuscitation. Nonetheless, technique selection should consider the child’s size, the rescuer’s strength, and the resuscitation context.