Document Detail

Effect of decreased inspiratory times on tidal volume. Bench model simulating cardiopulmonary resuscitation.
MedLine Citation:
PMID:  19557320     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: During cardiopulmonary resuscitation (CPR) with a chest compression rate of 60-100/min the time for secure undisturbed ventilation in the chest decompression phase is only 0.3-0.5 s and it is unclear which tidal volumes could be delivered in such a short time. OBJECTIVES: Attempts were made to assess the tidal volumes that can be insufflated in such a short time window. METHODS: In a bench model tidal volumes were compared in simulated non-intubated and intubated patients employing an adult self-inflating bag-valve with inspiratory times of 0.25, 0.3, and 0.5 s. Respiratory system compliance values were 60 mL/cmH(2)O being representative for respiratory system conditions shortly after onset of cardiac arrest and 20 mL/cmH(2)O being representative for conditions after prolonged cardiac arrest. RESULTS: With a respiratory system compliance of 60 mL/cmH(2)O, tidal volumes (mean+/-SD) in non-intubated versus intubated patients were 144+/-13 mL versus 196+/-23 mL in 0.25 s (p<0.01), 178+/-10 versus 270+/-14 mL in 0.3 s (p<0.01), and 310+/-12 mL versus 466+/-20 mL in 0.5 s (p<0.01). With a respiratory system compliance of 20 mL/cmH(2)O, tidal volumes in non-intubated patient versus intubated patients were 128+/-10 mL versus 186+/-20 mL in 0.25 s (p<0.01), 158+/-17 versus 250+/-14 mL in 0.3 s (p<0.01) and 230+/-21 mL versus 395+/-20 mL in 0.5 s (p<0.01). CONCLUSIONS: Ventilation windows of 0.25, 0.3, and 0.5 s were too short to provide adequate tidal volumes in a simulated non-intubated cardiac arrest patient. In a simulated intubated cardiac arrest patient, ventilation windows of at least 0.5 s were necessary to provide adequate tidal volumes.
H Herff; K Bowden; P Paal; T Mitterlechner; A von Goedecke; K H Lindner; V Wenzel
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Der Anaesthesist     Volume:  58     ISSN:  1432-055X     ISO Abbreviation:  Anaesthesist     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-24     Completed Date:  2009-10-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370525     Medline TA:  Anaesthesist     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  686-90     Citation Subset:  IM    
Department of Anesthesiology and Critical Care Medicine, Innsbruck Medical University, Anichstr. 35, 6020, Innsbruck, Osterreich.
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MeSH Terms
Air Pressure
Cardiopulmonary Resuscitation*
Computer Simulation
Heart Arrest / physiopathology,  therapy
Intubation, Intratracheal
Models, Statistical
Respiratory Function Tests
Respiratory Mechanics / physiology*
Tidal Volume / physiology*

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