Korean J Crit Care Med.  2015 May;30(2):89-94. 10.4266/kjccm.2015.30.2.89.

The Adequacy of a Conventional Mechanical Ventilator as a Ventilation Method during Cardiopulmonary Resuscitation: A Manikin Study

• Ahn HJ
• Kim KD
• Jeong WJ
• Lee JW
• Yoo IS
• Ryu S

• KMID: 2227669
• DOI: http://doi.org/10.4266/kjccm.2015.30.2.89

Abstract

BACKGROUND
We conducted this study to verify whether a mechanical ventilator is adequate for cardiopulmonary resuscitation (CPR).
METHODS
A self-inflating bag resuscitator and a mechanical ventilator were used to test two experimental models: Model 1 (CPR manikin without chest compression) and Model 2 (CPR manikin with chest compression). Model 2 was divided into three subgroups according to ventilator pressure limits (P(limit)). The self-inflating bag resuscitator was set with a ventilation rate of 10 breaths/min with the volume-marked bag-valve procedure. The mode of the mechanical ventilator was set as follows: volume-controlled mandatory ventilation of tidal volume (Vt) 600 mL, an inspiration time of 1.2 seconds, a constant flow pattern, a ventilation rate of 10 breaths/minute, a positive end expiratory pressure of 3 cmH2O and a maximum trigger limit. Peak airway pressure (P(peak)) and Vt were measured by a flow analyzer. Ventilation adequacy was determined at a Vt range of 400-600 mL with a P(peak) of < or = 50 cmH2O.
RESULTS
In Model 1, Vt and P(peak) were in the appropriate range in the ventilation equipments. In Model 2, for the self-inflating bag resuscitator, the adequate Vt and P(peak) levels were 17%, and the P(peak) adequacy was 20% and the Vt was 65%. For the mechanical ventilator, the adequate Vt and P(peak) levels were 85%; the P(peak) adequacy was 85%; and the Vt adequacy was 100% at 60 cmH2O of P(limit).
CONCLUSIONS
In a manikin model, a mechanical ventilator was superior to self-inflating bag resuscitator for maintaining adequate ventilation during chest compression.

Keyword

cardiopulmonary resuscitation; peak airway pressure; pressure limit; self-inflating bag resuscitator; tidal volume; ventilator

MeSH Terms

Cardiopulmonary Resuscitation*
Manikins*
Models, Theoretical
Positive-Pressure Respiration
Thorax
Tidal Volume
Ventilation*
Ventilators, Mechanical*

Figure

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  Fig. 1. Closed loop manikin circuit connected to flow analyzer

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  Fig. 2. Changes of the tidal volume and peak airway pressure in Model 2. Model 2; CPR Manikin with compression, Resuscitator; self-inflating bag resuscitator, ventilator 1; Plimit 40 cmH2O, 2; Plimit 50 cmH2O, 3; Plimit 60 cmH2O, Tidal volume adequacy; Vt 400-600 mL, Peak airway pressure adequacy; Ppeak ≤ 50 cmH2O, Adequate ventilation; Vt 400-600 mL and Ppeak ≤ 50 cmH2O

Reference

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