Body mass index and thoracic subcutaneous adipose tissue depth: Possible implications for adequacy of chest compressions

Abstract

Objective: Adequacy of cardiopulmonary resuscitation relies on compression of the thoracic cage to produce changes in intra-thoracic pressures sufficient to generate a pressure gradient. In order to evaluate the efficacy of cardiopulmonary resuscitation in morbid obesity, it is first necessary to determine the depth of thoracic subcutaneous adipose tissue (SAT) and to correlate this with body mass index (BMI). Results: Computerised-tomography images of the thorax of 55 patients with a diagnosis of obesity or morbid obesity (mean BMI 45.95 kg/m2) were evaluated to determine the depth of SAT at the level at which chest compressions would be applied by a trained rescuer, and correlated with BMI. Mean anterior SAT was 36.53 mm, and mean posterior SAT was 50.73 mm. There was a significant correlation between BMI and anterior and posterior SAT for males (p < 0.05 for both), and females (p < 0.05 for both). The slope of the functions was considered sufficiently close to allow combining the data. This also showed a significant correlation between SAT and BMI (p < 0.01 for both). Both anterior and posterior SAT is correlated with BMI. This data allows development of a model to explore the efficacy of chest compressions in morbid obesity.