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A Turbine-Driven Ventilator Improves Adherence to Advanced Cardiac Life Support Guidelines During a Cardiopulmonary Resuscitation Simulation.
Allen, Scott G; Brewer, Lara; Gillis, Erik S; Pace, Nathan L; Sakata, Derek J; Orr, Joseph A.
Afiliação
  • Allen SG; Department of Anesthesiology, University of Utah, Salt Lake City, Utah. scott.allen@hsc.utah.edu.
  • Brewer L; Department of Anesthesiology, University of Utah, Salt Lake City, Utah.
  • Gillis ES; Physician Assistant School at Duke University, Durham, North Carolina.
  • Pace NL; Department of Anesthesiology, University of Utah, Salt Lake City, Utah.
  • Sakata DJ; Department of Anesthesiology, University of Utah.
  • Orr JA; Department of Anesthesiology, University of Utah, Salt Lake City, Utah.
Respir Care ; 62(9): 1166-1170, 2017 Sep.
Article em En | MEDLINE | ID: mdl-28807986
BACKGROUND: Research has shown that increased breathing frequency during cardiopulmonary resuscitation is inversely correlated with systolic blood pressure. Rescuers often hyperventilate during cardiopulmonary resuscitation (CPR). Current American Heart Association advanced cardiac life support recommends a ventilation rate of 8-10 breaths/min. We hypothesized that a small, turbine-driven ventilator would allow rescuers to adhere more closely to advanced cardiac life support (ACLS) guidelines. METHODS: Twenty-four ACLS-certified health-care professionals were paired into groups of 2. Each team performed 4 randomized rounds of 2-min cycles of CPR on an intubated mannikin, with individuals altering between compressions and breaths. Two rounds of CPR were performed with a self-inflating bag, and 2 rounds were with the ventilator. The ventilator was set to deliver 8 breaths/min, pressure limit 22 cm H2O. Frequency, tidal volume (VT), peak inspiratory pressure, and compression interruptions (hands-off time) were recorded. Data were analyzed with a linear mixed model and Welch 2-sample t test. RESULTS: The median (interquartile range [IQR]) frequency with the ventilator was 7.98 (7.98-7.99) breaths/min. Median (IQR) frequency with the self-inflating bag was 9.5 (8.2-10.7) breaths/min. Median (IQR) ventilator VT was 0.5 (0.5-0.5) L. Median (IQR) self-inflating bag VT was 0.6 (0.5-0.7) L. Median (IQR) ventilator peak inspiratory pressure was 22 (22-22) cm H2O. Median (IQR) self-inflating bag peak inspiratory pressure was 30 (27-35) cm H2O. Mean ± SD hands-off times for ventilator and self-inflating bag were 5.25 ± 2.11 and 6.41 ± 1.45 s, respectively. CONCLUSIONS: When compared with a ventilator, volunteers ventilated with a self-inflating bag within ACLS guidelines. However, volunteers ventilated with increased variation, at higher VT levels, and at higher peak pressures with the self-inflating bag. Hands-off time was also significantly lower with the ventilator. (ClinicalTrials.gov registration NCT02743299.).
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Insuflação / Ventiladores Mecânicos / Fidelidade a Diretrizes / Suporte Vital Cardíaco Avançado / Treinamento por Simulação Tipo de estudo: Clinical_trials / Guideline / Prognostic_studies Limite: Adult / Female / Humans / Male Idioma: En Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Insuflação / Ventiladores Mecânicos / Fidelidade a Diretrizes / Suporte Vital Cardíaco Avançado / Treinamento por Simulação Tipo de estudo: Clinical_trials / Guideline / Prognostic_studies Limite: Adult / Female / Humans / Male Idioma: En Ano de publicação: 2017 Tipo de documento: Article