Effects of inspired gas content during respiratory arrest and cardiopulmonary resuscitation

Research output: Contribution to journalReview article

8 Scopus citations

Abstract

Mouth-to-mouth and bag-valve-mask ventilation have been an indispensable part of cardiopulmonary resuscitation (CPR). However, only recently have the effects of different tidal volumes on arterial oxygenation been reported for mouth-to-mouth and bag-valve-mask ventilation. Currently recommended tidal volumes (10-15 mL/kg) are associated with an increased risk of gastric inflation because they produce high peak inspiratory pressures. An animal model of ventilation with an unprotected airway showed that a smaller tidal volume (6 mL/kg) is as effective as a larger tidal volume (12 mL/kg) in maintaining SaO2 at >96%. However, a smaller tidal volume with exhaled gas ventilation produced a mean SaO2 of 48%, which is ineffective. Ventilation gas mixtures have been studied in models of cardiac arrest and CPR. One study showed that ventilation with air during 6 mins of CPR resulted in a return of spontaneous circulation in 10 of 12 animals compared with only 5 of 12 animals ventilated with exhaled gas (p < .04). Arterial and mixed-venous PO2 were significantly higher, and PCO2 was significantly lower in the air ventilation group. Investigations of the cardiovascular effects of mouth-to-mouth ventilation during CPR suggest that there are adverse effects during low blood flow states. However, mouth-to-mouth ventilation during respiratory arrest is lifesaving and should continue to be taught and emphasized in basic life support courses.

Original languageEnglish (US)
Pages (from-to)N196-N198
JournalCritical care medicine
Volume28
Issue number11 SUPPL.
StatePublished - Dec 7 2000

Keywords

  • Acidosis
  • Artificial ventilation
  • Bag-valve-mask ventilation
  • Cardiac arrest
  • Cardiopulmonary resuscitation
  • Hypercarbia
  • Hypoxemia
  • Mouth-to-mouth ventilation
  • Ventilation

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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