Optimum Chest Compression Point for CPR in Children Revisited Using a 3D Coordinate System Imposed on CT

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The optimum chest compression site (P_optimum) in children is debated: European Resuscitation Council recommends one finger breadth above the xiphisternal joint, whereas American Heart Association proposes the lower sternal half. Theoretically, pediatric P_optimum is located 1 cm (or 0.1 unit of sternal top) above the xiphisternal joint. We defined zero point (0, 0) as the center of the xiphisternal joint designating leftward and upward directions of the patients as positive on each axis. P_optimum (x_max. left ventricle, y_max. left ventricle) was defined as the center of the maximum diameter of the left ventricle, whereas P_aorta (x_aorta, y_aorta) as that of the aortic annulus. To compress the left ventricle exclusively, y_max. left ventricle should range above the y coordinate of hepatic dome (y_liver_dome) and below y_aorta.

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