[Okayama University] A 'Breath' to Save Drowning Children: Current Status and Impact of Decreased Artificial Respiration in Citizen Resuscitation

March 29, 2026 National University Corporation Okayama University https://www.okayama-u.ac.jp/

・Drowning is a representative cause of respiratory failure due to hypoxia, making resuscitation (ventilation) including artificial respiration crucial.

・Using the "All-Japan Utstein Registry" managed by the Fire and Disaster Management Agency, we examined changes in resuscitation methods and their impact on outcomes for pediatric out-of-hospital cardiac arrests related to drowning from 2012 to 2023.

・The results showed a decrease in the administration of artificial respiration and an increase in chest compression-only resuscitation. Furthermore, chest compression-only resuscitation was found to be associated with an increased risk of death and severe sequelae.

◆ Overview Cardiac arrest due to childhood drowning is primarily caused by respiratory arrest leading to a hypoxic state, making resuscitation methods (CPR) that include "artificial respiration" in addition to chest compressions particularly important. However, in recent years, the widespread adoption of "chest compression-only" resuscitation for adult cardiac arrest, along with concerns about infectious diseases, has led to a potential decline in the rate of artificial respiration.

A research group at the Department of Community Emergency and Disaster Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences (Medicine), National University Corporation Okayama University (Headquarters: Okayama City, Okayama Prefecture, President: Yasutomo Nasu), including specially appointed lecturer Takashi Kohara, specially appointed lecturer Go Nojima from the Department of Community Secondary Emergency and Disaster Medicine Promotion, lecturer Kohei Tsukahara from the Department of Medical Development, Associate Professor Hiromichi Naito and Professor Atsunori Nakao from the Department of Emergency and Critical Care Medicine and Disaster Medicine, in collaboration with Assistant Professor Naomi Matsumoto and Professor Takashi Yorifuji from the Department of Epidemiology and Public Health, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences (Medicine), used the "All-Japan Utstein Registry" (Fire and Disaster Management Agency) to investigate changes in bystander resuscitation methods and their association with outcomes in pediatric out-of-hospital cardiac arrest cases due to drowning that occurred between 2012 and 2023.

The results revealed that despite the importance of resuscitation methods involving artificial respiration for cardiac arrest due to drowning, the implementation rate has been declining in recent years. Furthermore, chest compression-only resuscitation was found to be associated with a higher risk of death and severe sequelae compared to resuscitation including artificial respiration. Even when analyzing cases where the cardiac arrest was not witnessed, a similar trend was observed, suggesting the importance of performing resuscitation including artificial respiration upon discovery, even if the drowning incident itself was not directly observed.

This research reaffirms the importance of resuscitation methods including artificial respiration in cases of pediatric cardiac arrest due to drowning. It highlights the need for societal efforts such as enhancing pediatric resuscitation education for the general public and promoting the use of pocket masks for safe artificial respiration.

These research findings were published on March 10, 2026, in the journal *Resuscitation* by Elsevier in the Netherlands.

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