{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T05:42:15Z","timestamp":1793425335553,"version":"4.5.0"},"reference-count":43,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Res"],"DOI":"10.1038\/s41390-026-05328-2","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T06:48:27Z","timestamp":1785221307000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of rescuer rotation on metrics of neonatal chest compression: a simulation study"],"prefix":"10.1038","author":[{"given":"Minjie","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangfang","family":"Tao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohong","family":"Xi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoying","family":"Gu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenyan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiang-Qin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg M.","family":"Schm\u00f6lzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po-Yin","family":"Cheung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"5328_CR1","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1097\/JPN.0b013e318253e1aa","volume":"26","author":"JE McGowan","year":"2012","unstructured":"McGowan, J. E. Neonatal resuscitation science, education, and practice: the role of the neonatal resuscitation program. J. Perinat. Neonatal Nurs. 26, 158\u2013163 (2012).","journal-title":"J. Perinat. Neonatal Nurs."},{"key":"5328_CR2","first-page":"S385","volume":"152","author":"HC Lee","year":"2025","unstructured":"Lee, H. C. et al. Part 5: neonatal resuscitation: 2025 American Heart Association and American Academy of Pediatrics Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 152, S385\u2013S423 (2025).","journal-title":"Circulation"},{"key":"5328_CR3","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1001\/archpedi.1995.02170130022005","volume":"149","author":"JM Perlman","year":"1995","unstructured":"Perlman, J. M. & Risser, R. Cardiopulmonary resuscitation in the delivery room. Associated clinical events. Arch. Pediatr. Adolesc. Med. 149, 20\u201325 (1995).","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"5328_CR4","doi-asserted-by":"publisher","first-page":"151624","DOI":"10.1016\/j.semperi.2022.151624","volume":"46","author":"S Ramachandran","year":"2022","unstructured":"Ramachandran, S., Bruckner, M., Kapadia, V. & Schmolzer, G. M. Chest compressions and medications during neonatal resuscitation. Semin. Perinatol. 46, 151624 (2022).","journal-title":"Semin. Perinatol."},{"key":"5328_CR5","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1136\/archdischild-2022-324529","volume":"108","author":"S Ramachandran","year":"2023","unstructured":"Ramachandran, S., Bruckner, M., Wyckoff, M. H. & Schmolzer, G. M. Chest compressions in newborn infants: a scoping review. Arch. Dis. Child. Fetal Neonatal Ed. 108, 442\u2013450 (2023).","journal-title":"Arch. Dis. Child. Fetal Neonatal Ed."},{"key":"5328_CR6","first-page":"299","volume":"14","author":"PA Steen","year":"2008","unstructured":"Steen, P. A. & Kramer-Johansen, J. Improving cardiopulmonary resuscitation quality to ensure survival. Curr. Opin. Crit. Care 14, 299\u2013304 (2008).","journal-title":"Curr. Opin. Crit. Care"},{"key":"5328_CR7","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1038\/jp.2014.165","volume":"35","author":"ES Li","year":"2015","unstructured":"Li, E. S., Cheung, P. Y., O\u2019Reilly, M., Aziz, K. & Schmolzer, G. M. Rescuer fatigue during simulated neonatal cardiopulmonary resuscitation. J. Perinatol. 35, 142\u2013145 (2015).","journal-title":"J. Perinatol."},{"key":"5328_CR8","doi-asserted-by":"publisher","first-page":"796","DOI":"10.1055\/s-0037-1620231","volume":"35","author":"D Enriquez","year":"2018","unstructured":"Enriquez, D., Meritano, J., Shah, B. A., Song, C. & Szyld, E. Fatigue during chest compression using a neonatal patient simulator. Am. J. Perinatol. 35, 796\u2013800 (2018).","journal-title":"Am. J. Perinatol."},{"key":"5328_CR9","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1161\/hc0502.102963","volume":"105","author":"KB Kern","year":"2002","unstructured":"Kern, K. B., Hilwig, R. W., Berg, R. A., Sanders, A. B. & Ewy, G. A. Importance of continuous chest compressions during cardiopulmonary resuscitation: improved outcome during a simulated single lay-rescuer scenario. Circulation 105, 645\u2013649 (2002).","journal-title":"Circulation"},{"key":"5328_CR10","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1001\/jama.293.3.299","volume":"293","author":"L Wik","year":"2005","unstructured":"Wik, L. et al. Quality of cardiopulmonary resuscitation during out-of-hospital cardiac arrest. JAMA 293, 299\u2013304 (2005).","journal-title":"JAMA"},{"key":"5328_CR11","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1001\/jama.293.3.305","volume":"293","author":"BS Abella","year":"2005","unstructured":"Abella, B. S. et al. Quality of cardiopulmonary resuscitation during in-hospital cardiac arrest. JAMA 293, 305\u2013310 (2005).","journal-title":"JAMA"},{"key":"5328_CR12","doi-asserted-by":"publisher","first-page":"e43","DOI":"10.1016\/j.resuscitation.2015.07.041","volume":"95","author":"GD Perkins","year":"2015","unstructured":"Perkins, G. D. et al. Part 3: adult basic life support and automated external defibrillation: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Resuscitation 95, e43\u2013e69 (2015).","journal-title":"Resuscitation"},{"key":"5328_CR13","doi-asserted-by":"publisher","first-page":"e0265072","DOI":"10.1371\/journal.pone.0265072","volume":"17","author":"T Sandhu","year":"2022","unstructured":"Sandhu, T., Szyld, E. G., Anderson, M. P. & Shah, B. A. Effect of rotating providers on chest compression performance during simulated neonatal cardiopulmonary resuscitation. PLoS ONE 17, e0265072 (2022).","journal-title":"PLoS ONE"},{"key":"5328_CR14","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1097\/MEJ.0b013e328345340f","volume":"18","author":"SM Ock","year":"2011","unstructured":"Ock, S. M., Kim, Y. M., Chung, J. & Kim, S. H. Influence of physical fitness on the performance of 5-minute continuous chest compression. Eur. J. Emerg. Med. 18, 251\u2013256 (2011).","journal-title":"Eur. J. Emerg. Med."},{"key":"5328_CR15","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1038\/s41390-023-02827-4","volume":"95","author":"M O\u2019Reilly","year":"2024","unstructured":"O\u2019Reilly, M., Lee, T. F., Cheung, P. Y. & Schmolzer, G. M. Comparison of hemodynamic effects of chest compression delivered via machine or human in asphyxiated piglets. Pediatr. Res. 95, 156\u2013159 (2024).","journal-title":"Pediatr. Res."},{"key":"5328_CR16","doi-asserted-by":"publisher","first-page":"1455","DOI":"10.1055\/s-0039-1693990","volume":"37","author":"KA Ahmad","year":"2020","unstructured":"Ahmad, K. A. et al. The characteristics and outcomes of cardiopulmonary resuscitation within the neonatal intensive care unit based on gestational age and unit level of care. Am. J. Perinatol. 37, 1455\u20131461 (2020).","journal-title":"Am. J. Perinatol."},{"key":"5328_CR17","doi-asserted-by":"publisher","first-page":"e797","DOI":"10.1542\/peds.2012-1892","volume":"131","author":"O Badaki-Makun","year":"2013","unstructured":"Badaki-Makun, O. et al. Chest compression quality over time in pediatric resuscitations. Pediatrics 131, e797\u2013e804 (2013).","journal-title":"Pediatrics"},{"key":"5328_CR18","first-page":"e58","volume":"13","author":"C Sawee","year":"2025","unstructured":"Sawee, C., Churuangsuk, C. & Vattanavanit, V. Effect of compression rotation intervals on cardiopulmonary resuscitation quality: a systematic review and meta-analysis. Arch. Acad. Emerg. Med. 13, e58 (2025).","journal-title":"Arch. Acad. Emerg. Med."},{"key":"5328_CR19","doi-asserted-by":"publisher","first-page":"e33066","DOI":"10.1097\/MD.0000000000033066","volume":"102","author":"DH Kim","year":"2023","unstructured":"Kim, D. H., Seo, Y. W. & Jang, T. C. CPR quality with rotation of every 1 versus 2 minutes as characteristics of rescuers: a randomized crossover simulation study. Medicine 102, e33066 (2023).","journal-title":"Medicine"},{"key":"5328_CR20","doi-asserted-by":"publisher","first-page":"879","DOI":"10.1016\/j.resuscitation.2014.02.026","volume":"85","author":"T Rea","year":"2014","unstructured":"Rea, T., Olsufka, M., Yin, L., Maynard, C. & Cobb, L. The relationship between chest compression fraction and outcome from ventricular fibrillation arrests in prolonged resuscitations. Resuscitation 85, 879\u2013884 (2014).","journal-title":"Resuscitation"},{"key":"5328_CR21","doi-asserted-by":"publisher","first-page":"S424","DOI":"10.1161\/CIR.0000000000001370","volume":"152","author":"BL Joyner Jr.","year":"2025","unstructured":"Joyner, B. L. Jr. et al. Part 6: pediatric basic life support: 2025 American Heart Association and American Academy of Pediatrics Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 152, S424\u2013S447 (2025).","journal-title":"Circulation"},{"key":"5328_CR22","doi-asserted-by":"publisher","first-page":"1493","DOI":"10.1161\/CIRCULATIONAHA.123.066882","volume":"149","author":"KG Lauridsen","year":"2024","unstructured":"Lauridsen, K. G. et al. Association between chest compression pause duration and survival after pediatric in-hospital cardiac arrest. Circulation 149, 1493\u20131500 (2024).","journal-title":"Circulation"},{"key":"5328_CR23","doi-asserted-by":"crossref","unstructured":"Stuby, L. et al. Effect on chest compression fraction of continuous manual compressions with asynchronous ventilations using an I-Gel\u00ae versus 30:2 approach during simulated out-of-hospital cardiac arrest: protocol for a manikin multicenter randomized controlled trial. Healthcare 9, 354 (2021).","DOI":"10.3390\/healthcare9030354"},{"key":"5328_CR24","doi-asserted-by":"publisher","first-page":"111117","DOI":"10.1016\/j.resuscitation.2026.111117","volume":"224","author":"C Liu","year":"2026","unstructured":"Liu, C., Kudenchuk, P. K., Rea, T. & Kwok, H. The CPR Compression Matrix: relationship among depth, recoil, and rate. Resuscitation 224, 111117 (2026).","journal-title":"Resuscitation"},{"key":"5328_CR25","doi-asserted-by":"publisher","first-page":"21","DOI":"10.5603\/KP.a2016.0165","volume":"75","author":"C Abelairas-Gomez","year":"2017","unstructured":"Abelairas-Gomez, C. et al. The effect of strength training on quality of prolonged basic cardiopulmonary resuscitation. Kardiol. Pol. 75, 21\u201327 (2017).","journal-title":"Kardiol. Pol."},{"key":"5328_CR26","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1016\/j.resuscitation.2018.06.037","volume":"130","author":"JK Russell","year":"2018","unstructured":"Russell, J. K., Gonzalez-Otero, D. M., Ruiz de Gauna, S., Daya, M. & Ruiz, J. Can chest compression release rate or recoil velocity identify rescuer leaning in out-of-hospital cardiopulmonary resuscitation?. Resuscitation 130, 133\u2013137 (2018).","journal-title":"Resuscitation"},{"key":"5328_CR27","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1016\/j.resuscitation.2019.07.023","volume":"142","author":"DM Gonzalez-Otero","year":"2019","unstructured":"Gonzalez-Otero, D. M. et al. Association of chest compression and recoil velocities with depth and rate in manual cardiopulmonary resuscitation. Resuscitation 142, 119\u2013126 (2019).","journal-title":"Resuscitation"},{"key":"5328_CR28","doi-asserted-by":"publisher","first-page":"1064","DOI":"10.1001\/jama.1960.03020280004002","volume":"173","author":"WB Kouwenhoven","year":"1960","unstructured":"Kouwenhoven, W. B., Jude, J. R. & Knickerbocker, G. G. Closed-chest cardiac massage. JAMA 173, 1064\u20131067 (1960).","journal-title":"JAMA"},{"key":"5328_CR29","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1016\/S0140-6736(80)90662-5","volume":"1","author":"N Chandra","year":"1980","unstructured":"Chandra, N., Rudikoff, M. & Weisfeldt, M. L. Simultaneous chest compression and ventilation at high airway pressure during cardiopulmonary resuscitation. Lancet 1, 175\u2013178 (1980).","journal-title":"Lancet"},{"key":"5328_CR30","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1161\/01.CIR.61.2.345","volume":"61","author":"MT Rudikoff","year":"1980","unstructured":"Rudikoff, M. T., Maughan, W. L., Effron, M., Freund, P. & Weisfeldt, M. L. Mechanisms of blood flow during cardiopulmonary resuscitation. Circulation 61, 345\u2013352 (1980).","journal-title":"Circulation"},{"key":"5328_CR31","doi-asserted-by":"publisher","first-page":"1053","DOI":"10.1016\/0002-9149(81)90320-9","volume":"48","author":"N Chandra","year":"1981","unstructured":"Chandra, N. et al. Augmentation of carotid flow during cardiopulmonary resuscitation by ventilation at high airway pressure simultaneous with chest compression. Am. J. Cardiol. 48, 1053\u20131063 (1981).","journal-title":"Am. J. Cardiol."},{"key":"5328_CR32","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1161\/01.CIR.67.2.266","volume":"67","author":"RC Koehler","year":"1983","unstructured":"Koehler, R. C. et al. Augmentation of cerebral perfusion by simultaneous chest compression and lung inflation with abdominal binding after cardiac arrest in dogs. Circulation 67, 266\u2013275 (1983).","journal-title":"Circulation"},{"key":"5328_CR33","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1161\/01.RES.56.1.20","volume":"56","author":"AD Guerci","year":"1985","unstructured":"Guerci, A. D. et al. Transmission of intrathoracic pressure to the intracranial space during cardiopulmonary resuscitation in dogs. Circ. Res. 56, 20\u201330 (1985).","journal-title":"Circ. Res."},{"key":"5328_CR34","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1161\/01.CIR.73.3.539","volume":"73","author":"HR Halperin","year":"1986","unstructured":"Halperin, H. R. et al. Determinants of blood flow to vital organs during cardiopulmonary resuscitation in dogs. Circulation 73, 539\u2013550 (1986).","journal-title":"Circulation"},{"key":"5328_CR35","doi-asserted-by":"publisher","first-page":"558","DOI":"10.1203\/00006450-198912000-00006","volume":"26","author":"ID Berkowitz","year":"1989","unstructured":"Berkowitz, I. D. et al. Blood flow during cardiopulmonary resuscitation with simultaneous compression and ventilation in infant pigs. Pediatr. Res. 26, 558\u2013564 (1989).","journal-title":"Pediatr. Res."},{"key":"5328_CR36","doi-asserted-by":"publisher","first-page":"F270","DOI":"10.1136\/archdischild-2025-329582","volume":"111","author":"CT Chua","year":"2026","unstructured":"Chua, C. T., O\u2019Reilly, M., Surak, A. & Schmolzer, G. M. Chest compression in newborn infants: What anatomical structures are we compressing?. Arch. Dis. Child. Fetal Neonatal Ed. 111, F270\u2013F274 (2026).","journal-title":"Arch. Dis. Child. Fetal Neonatal Ed."},{"key":"5328_CR37","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.1111\/j.1553-2712.2000.tb01255.x","volume":"7","author":"ML Dorfsman","year":"2000","unstructured":"Dorfsman, M. L., Menegazzi, J. J., Wadas, R. J. & Auble, T. E. Two-thumb vs. two-finger chest compression in an infant model of prolonged cardiopulmonary resuscitation. Acad. Emerg. Med. 7, 1077\u20131082 (2000).","journal-title":"Acad. Emerg. Med."},{"key":"5328_CR38","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1136\/archdischild-2012-302583","volume":"98","author":"PS Martin","year":"2013","unstructured":"Martin, P. S., Kemp, A. M., Theobald, P. S., Maguire, S. A. & Jones, M. D. Do chest compressions during simulated infant CPR comply with international recommendations?. Arch. Dis. Child. 98, 576\u2013581 (2013).","journal-title":"Arch. Dis. Child."},{"key":"5328_CR39","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1136\/archdischild-2018-314893","volume":"104","author":"JL Pellegrino","year":"2019","unstructured":"Pellegrino, J. L., Bogumil, D., Epstein, J. L. & Burke, R. V. Two-thumb-encircling advantageous for lay responder infant CPR: a randomised manikin study. Arch. Dis. Child. 104, 530\u2013534 (2019).","journal-title":"Arch. Dis. Child."},{"key":"5328_CR40","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1016\/j.resuscitation.2019.08.042","volume":"146","author":"J Considine","year":"2020","unstructured":"Considine, J. et al. Chest compression components (rate, depth, chest wall recoil and leaning): a scoping review. Resuscitation 146, 188\u2013202 (2020).","journal-title":"Resuscitation"},{"key":"5328_CR41","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.resuscitation.2022.05.004","volume":"177","author":"KG Lauridsen","year":"2022","unstructured":"Lauridsen, K. G. et al. Association of chest compression pause duration prior to E-CPR cannulation with cardiac arrest survival outcomes. Resuscitation 177, 85\u201392 (2022).","journal-title":"Resuscitation"},{"key":"5328_CR42","doi-asserted-by":"publisher","first-page":"1015","DOI":"10.1016\/j.resuscitation.2009.05.014","volume":"80","author":"S Manders","year":"2009","unstructured":"Manders, S. & Geijsel, F. E. Alternating providers during continuous chest compressions for cardiac arrest: Every minute or every two minutes?. Resuscitation 80, 1015\u20131018 (2009).","journal-title":"Resuscitation"},{"key":"5328_CR43","doi-asserted-by":"publisher","first-page":"980","DOI":"10.5603\/KP.a2018.0030","volume":"76","author":"J Smereka","year":"2018","unstructured":"Smereka, J. et al. Which position should we take during newborn resuscitation? A prospective, randomised, multicentre simulation trial. Kardiol. Pol. 76, 980\u2013986 (2018).","journal-title":"Kardiol. Pol."}],"container-title":["Pediatric Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41390-026-05328-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41390-026-05328-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41390-026-05328-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T17:14:51Z","timestamp":1793380491000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41390-026-05328-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,28]]},"references-count":43,"alternative-id":["5328"],"URL":"https:\/\/doi.org\/10.1038\/s41390-026-05328-2","relation":{},"ISSN":["0031-3998","1530-0447"],"issn-type":[{"value":"0031-3998","type":"print"},{"value":"1530-0447","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,28]]},"assertion":[{"value":"4 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 June 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 June 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 July 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"The requirement for informed consent was waived due to the absence of patient involvement.","order":2,"name":"Ethics","label":"Consent statement","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"The study was approved by the Ethics Committee of the Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine (approval number KS25494).","order":3,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Ethics"}}]}}