Document Detail


What is the optimal chest compression-ventilation ratio?
MedLine Citation:
PMID:  15928467     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: Despite a more widespread knowledge of basic cardiopulmonary resuscitation maneuvers in the community, the survival rate for patients with cardiac arrest has remained essentially unchanged in the past 30 years. Over the past few decades, many different compression-ventilation ratios have been studied in terms of best coronary and cerebral oxygen delivery, restoration of spontaneous circulation, and neurologic outcome. This article summarizes the recent evidence presented at the International Consensus on Resuscitation Science in January 2005. RECENT FINDINGS: Recent data from animal and mathematical models suggest a move to a higher compression-ventilation ratio to maximize coronary and cerebral oxygen delivery during cardiac arrest and long-term neurologic outcome. Prospective randomized human data on alternative compression-ventilation ratios are missing and new evidence seems to indicate the inadequacy of both lay and professional rescuers in providing chest compression and ventilating the victim in cardiac arrest. Finally, observational and animal studies highlight the hidden danger of inadvertent hyperventilation during advanced cardiac life support as a reduction of both coronary and perfusion pressure secondary to increased intrathoracic pressure and decreased venous return. SUMMARY: The optimal compression-ventilation ratio is still unknown and the best tradeoff between oxygenation and organ perfusion during cardiopulmonary resuscitation is probably different for each patient and scenario. A discrepancy between what is recommended by the current guidelines and the 'real world' of cardiopulmonary resuscitation has resulted in a near flat survival rate from cardiac arrest in the past few years.
Authors:
Peter Fenici; A H Idris; K G Lurie; Stefano Ursella; Andrea Gabrielli
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in critical care     Volume:  11     ISSN:  1070-5295     ISO Abbreviation:  Curr Opin Crit Care     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-06-01     Completed Date:  2005-10-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9504454     Medline TA:  Curr Opin Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  204-11     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Catholic University Hospital of Rome, Italy.
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MeSH Terms
Descriptor/Qualifier:
Cardiopulmonary Resuscitation / methods*,  standards
Heart Arrest / therapy
Humans
Models, Animal
Models, Statistical
Oxygen Consumption
Pulmonary Ventilation*
Survival Rate
Time Factors
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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