Better outcomes seen for patients with ventilation waveforms in ≥50 percent of pauses in CPR
By Elana Gotkine HealthDay Reporter
FRIDAY, Nov. 17, 2023 (HealthDay News) — Lung inflation occurs infrequently with bag-valve-mask ventilation during 30:2 cardiopulmonary resuscitation, according to a study published online Nov. 12 in Circulation to coincide with the American Heart Association Scientific Sessions 2023, held from Nov. 11 to 13 in Philadelphia.
Ahamed H. Idris, M.D., from the University of Texas Southwestern Medical Center in Dallas, and colleagues studied patients with out-of-hospital cardiac arrest to examine the incidence of lung inflation with bag-valve-mask ventilation while assigned to 30:2 CPR (chest compressions interrupted by ventilation in a ratio of 30:2). A chest compression pause was defined as a 3- to 15-s break in compressions. Ventilation and outcomes were compared in patients with ventilation waveforms in <50 percent of pauses (group 1) and those with waveforms in ≥50 percent of pauses (group 2).
Data were included for 1,976 patients. The researchers found that the mean duration of 30:2 CPR was 9.8 ± 4.9 minutes from the start of chest compressions until advanced airway placement. A total of 26,861 pauses in chest compressions were identified during this period; based on ventilation waveforms, 60 percent of patients were in group 1 (1,177 patients) and 40 percent were in group 2 (799 patients). Per patient, groups 1 and 2 had a median of 12 pauses and two ventilations and 12 pauses and 12 ventilations, respectively. Higher rates of prehospital return of spontaneous circulation, survival to hospital discharge, and survival with favorable neurological outcome were seen in group 2. After adjustment for confounders, these associations persisted.
“Adequate ventilation through bag-valve-mask is a difficult skill to perform properly and must be practiced regularly to maintain proficiency,” Idris said in a statement.
Two authors disclosed ties to the biopharmaceutical and medical device industries.
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