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‘Keeping the beat’: What is the best way to perform neonatal chest compressions?
  1. Jonathan Cusack1,2
  1. 1 Neonatolgy, University Hospitals of Leicester NHS Trust, Leicester, UK
  2. 2 College of Life Sciences, University of Leicester, Leicester, UK
  1. Correspondence to Dr Jonathan Cusack, Neonatolgy, University Hospitals of Leicester NHS Trust, Leicester LE1 5WW, UK; jonathan.cusack{at}

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Ramachandran et al explore the evidence behind the recommendations surrounding chest compressions in the newborn infant.1

UK and European guidelines2 for neonatal resuscitation are produced following evidence reviews carried out by the International Liaison Committee on Resuscitation (ILCOR). This organisation produces Consensus on Science and Treatment Recommendations following extensive reviews of resuscitation literature. There is now a rapid, continuous review process so that new evidence makes its way quickly into guidelines. Ramachandran et al have published a scoping review on behalf of ILCOR providing the latest update to evidence behind neonatal chest compressions.

Cardiac compressions were first described in animal studies in 18743 but only became routine resuscitation practice in 1960, highlighting the need to have a better system so that evidence is rapidly assimilated into clinical practice!

Chest compressions are only rarely needed. Only 0.3% of infants receive chest compressions.4

This scoping review identified 74 studies, but in line with much resuscitation science, good-quality data in human studies were scarce. Only four of these studies were clinical studies and these included retrospective and observational studies.

What do we know about chest compressions?

Current UK and European Newborn Life support guidelines2 recommend that:

  • Compressions are performed in a ratio of three compressions to one ventilation breath.

  • Compressions should be performed to a depth of one-third of the anteroposterior diameter of the chest.

  • There should be 120 events per minute.

  • Compressions should be synchronous.

Following the scoping review, the authors conclude that they did not find …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

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