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Related Experiment Videos

High-pressure ventilation during CPR with 95% O2:5% CO2.

C F Babbs, K R Fitzgerald, W D Voorhees

    Critical Care Medicine
    |August 1, 1982
    PubMed
    Summary

    Ventilating dogs with pure oxygen during cardiopulmonary resuscitation (CPR) caused dangerous alkalemia. Adding 5% carbon dioxide (CO2) to the oxygen mixture prevented this, maintaining stable acid-base balance without altering blood flow during CPR.

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    Area of Science:

    • Cardiovascular Physiology
    • Respiratory Physiology
    • Critical Care Medicine

    Background:

    • High-pressure ventilation during cardiopulmonary resuscitation (CPR) can affect blood gas levels.
    • The choice of breathing gas mixture during CPR is critical for maintaining acid-base balance.
    • Previous studies have not fully elucidated the impact of different gas mixtures on hemodynamics and acid-base status during high-pressure CPR.

    Purpose of the Study:

    • To investigate the effects of pure oxygen versus 5% CO2-enriched oxygen on hemodynamics and acid-base balance during CPR in dogs.
    • To compare two ventilation modes (1:1 and 1:5) during high-pressure CPR.
    • To assess the impact of ventilation gas mixtures on the success of electrical defibrillation.

    Main Methods:

    • Dogs underwent cardiac arrest and CPR with high-pressure ventilation (50 cm H2O) using either pure oxygen or 5% CO2-enriched oxygen.

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  • Ventilation was delivered either simultaneously with compressions (1:1) or interposed after every fifth compression (1:5).
  • Cardiac output and regional blood flow (brain, heart, kidney) were measured using radioactive microspheres; arterial blood pH and PCO2 were monitored.

    • Main Results:

    • Ventilation with pure oxygen led to severe arterial alkalemia (pH ≈ 7.63) and hypocarbia (PCO2 ≈ 5.0-5.4) in both ventilation modes.
    • Ventilation with 5% CO2-enriched oxygen maintained arterial acid-base status near pre-arrest levels (pH ≈ 7.22-7.26, PCO2 ≈ 28.0-30.3).
    • No significant differences in cardiac output or regional blood flow were observed among the four conditions; electrical defibrillation was successful despite alkalemia.

    Conclusions:

    • High-pressure ventilation with CO2-enriched oxygen during CPR prevents severe arterial alkalemia and hypocarbia.
    • The chosen ventilation gas mixture during CPR does not significantly alter hemodynamics or regional blood flow.
    • Maintaining acid-base balance with CO2-enriched oxygen may be beneficial during CPR, without compromising defibrillation success.