Interposed abdominal compression CPR in pediatric cardiac arrest: early results from a multicenter comparison to standard CPR

Stromberg, D; Raymond, TT; Centers, G; Vaez, Z; Je, S; Thomas, A; Nadkarni, V; Howsmon, DP; PediRes-Q Investigators

doi:10.1016/j.resuscitation.2025.110676

Pediatric anesthesia & critical care

Interposed abdominal compression CPR in pediatric cardiac arrest: early results from a multicenter comparison to standard CPR

ResuscitationPublished 16 Jun 2025Prospective multicentre within-patient comparison study

Main finding · DBPResultIncrease 11.6 mmHg 95% CI 2.2–21.1

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Authors' conclusion

IAC-CPR was associated with significant improvements in both DBP and SBP compared to S-CPR technique in pediatric ICU patients with complex congenital heart disease.

Study context

Population: Children ≤3 years with cardiac arrest in pediatric cardiac ICUs (infants with complex congenital heart disease, mostly single ventricle, postoperative)
Participants: 17 children · 3 pediatric cardiac intensive care unit (PCICU) sites

Exposure: Interposed abdominal compression CPR (IAC-CPR) vs standard CPR (S-CPR)
Outcome: Diastolic blood pressure (DBP) during IAC-CPR vs S-CPR

Methodological detailsquality assurance collaborative, within-patient sequential epochs

Quality assurance collaborative
Within-patient sequential epochs

Main finding

DBP

Increase

11.6 mmHg

95% CI 2.2–21.1

P = 0.018

IAC-CPR vs S-CPR

increase 11.6 mmHg (95% CI 2.2–21.1); P = 0.018

As reported in the abstract

Observational data: associations, not effects.

Further findings

Outcome	← Lower with IAC-CPR ←→ Higher with IAC-CPR →	Increase (mmHg) (95% CI)	P value
Peak SBP	−2002040	15.4 (0.51–30.2)	P = 0.044
	−2002040Difference, mmHg (linear scale)

Peak systolic blood pressure (SBP): adjusted for non-stationarity and correlations in individual time series

Event outcomes (whole cohort)

Return of spontaneous circulation (ROSC): 11/17 (65%)
ROC with ECMO: 5/17 (29%)
Survival to hospital discharge or 30 days: 8/17 (47%)
Favorable neurologic outcome among survivors: all

Safety

Complications attributable to IAC-CPR: 0 · events

Original publication

Interposed abdominal compression CPR in pediatric cardiac arrest: early results from a multicenter comparison to standard CPR. Resuscitation. Published 16 June 2025. doi:10.1016/j.resuscitation.2025.110676

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