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Tidal volume delivery during continuous chest compressions and sustained inflation
A L Solevåg1,2,3, T-F Lee1,2, M Lu1,2
1Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Alberta, Canada.
Objective:
To determine the distending pressure needed to achieve sufficient tidal volume (VT) delivery during continuous chest compressions (CC) superimposed by sustained inflation (SI) (CC+SI).
Design:
Randomised animal/manikin trial.
Setting:
University laboratory.
Subjects:
Cadaver piglets/manikin.
Interventions:
SI distending pressures of 5, 10, 15, 20, 25 and 30 cm H2O were delivered in random order during CC+SI for 2 min each.
Main Outcome Measures:
VT, gas flow and airway pressure. Spearman's r for distending pressure and VT.
Results:
Distending pressure and VT correlated in cadaver piglets (r=0.83, p<0.001), manikin (r=0.98, p<0.001) and combined data (r=0.49, p<0.001). VT was delivered during chest recoil during CC in both models. In cadaver piglets, a distending pressure ∼25 cm H2O was needed to achieve an adequate VT.
Conclusions:
Chest recoil generates VT depending on an adequate distending pressure. This has previously been demonstrated in adult animals. A pressure of ∼25 cm H2O is needed to achieve an adequate VT delivery.
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