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KMID : 0604020150300020089
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Korean Journal of Critical Care Medicine
2015 Volume.30 No. 2 p.89 ~ p.94
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The Adequacy of a Conventional Mechanical Ventilator as a Ventilation Method during Cardiopulmonary Resuscitation: A Manikin Study
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Ahn Hong-Joon
Kim Kun-Dong
Jeong Won-Joon
Lee Jun-Wan
Yoo In-Sool
Ryu Seung
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Abstract
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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 (CPRmanikin without chest compression) and Model 2 (CPR manikin with chest compression). Model 2 was divided into three subgroupsaccording to ventilator pressure limits (Plimit). The self-inflating bag resuscitator was set with a ventilation rate of 10 breaths/min withthe volume-marked bag-valve procedure. The mode of the mechanical ventilator was set as follows: volume-controlled mandatoryventilation 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 (Ppeak) and Vt were measuredby a flow analyzer. Ventilation adequacy was determined at a Vt range of 400-600 mL with a Ppeak of ≤ 50 cmH2O.
Results: In Model 1, Vt and Ppeak were in the appropriate range in the ventilation equipments. In Model 2, for the self-inflating bag resuscitator,the adequate Vt and Ppeak levels were 17%, and the Ppeak adequacy was 20% and the Vt was 65%. For the mechanical ventilator,the adequate Vt and Ppeak levels were 85%; the Ppeak adequacy was 85%; and the Vt adequacy was 100% at 60 cmH2O of Plimit.
Conclusions: In a manikin model, a mechanical ventilator was superior to self-inflating bag resuscitator for maintaining adequateventilation during chest compression.
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KEYWORD
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cardiopulmonary resuscitation, peak airway pressure, pressure limit, self-inflating bag resuscitator, tidal volume, ventilator
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