Advertisement
Editorial| Volume 177, P41-42, August 2022

The importance of measuring ventilation during resuscitation

      Little is known about the details of ventilation in the prehospital setting mainly because it has not been adequately measured either in research studies or in practice. Measurement of end-tidal CO2 (ETCO2) has been widely available, but sporadically used in the Emergency Medical Services (EMS)-setting until recently where it is used to verify advanced airway placement and as a gauge of the adequacy of circulation during cardiopulmonary resuscitation (CPR).
      • Sandroni C.
      • De Santis P.
      • D'Arrigo S.
      Capnography during cardiac arrest.
      In addition, ETCO2 measurement is unable to provide information regarding respiratory mechanics such as tidal volume, airway pressure, and flow rate.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Resuscitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Sandroni C.
        • De Santis P.
        • D'Arrigo S.
        Capnography during cardiac arrest.
        Resuscitation. 2018; 132 (Epub 2018 Aug 22 PMID: 30142399): 73-77https://doi.org/10.1016/j.resuscitation.2018.08.018
        • Tremblay L.N.
        • Slutsky A.S.
        Ventilator-induced lung injury: from the bench to the bedside.
        Intensive Care Med. 2006; 32 (Epub 2005 Oct 18 PMID: 16231069): 24-33https://doi.org/10.1007/s00134-005-2817-8
        • Acute Respiratory Distress Syndrome Network
        • Brower R.G.
        • Matthay M.A.
        • et al.
        Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome.
        N Engl J Med. 2000; 342 (PMID: 10793162): 1301-1308https://doi.org/10.1056/NEJM200005043421801
        • Amato M.B.
        • Meade M.O.
        • Slutsky A.S.
        • et al.
        Driving pressure and survival in the acute respiratory distress syndrome.
        N Engl J Med. 2015; 372 (PMID: 25693014): 747-755https://doi.org/10.1056/NEJMsa1410639
        • Serpa Neto A.
        • Cardoso S.O.
        • Manetta J.A.
        • et al.
        Association between use of lung-protective ventilation with lower tidal volumes and clinical outcomes among patients without acute respiratory distress syndrome: a meta-analysis.
        JAMA. 2012; 308 (PMID: 23093163): 1651-1659https://doi.org/10.1001/jama.2012.13730
        • Fuller B.M.
        • Mohr N.M.
        • Drewry A.M.
        • Carpenter C.R.
        Lower tidal volume at initiation of mechanical ventilation may reduce progression to acute respiratory distress syndrome: a systematic review.
        Crit Care. 2013; 17 (PMID: 23331507; PMCID: PMC3983656): R11https://doi.org/10.1186/cc11936
        • Johnson N.J.
        • Caldwell E.
        • Carlbom D.J.
        • et al.
        The acute respiratory distress syndrome after out-of-hospital cardiac arrest: Incidence, risk factors, and outcomes.
        Resuscitation. 2019; 135 (Epub 2019 Jan 14 PMID: 30654012): 37-44https://doi.org/10.1016/j.resuscitation.2019.01.009
        • Yang B.Y.
        • Blackwood J.E.
        • Shin J.
        • et al.
        A pilot evaluation of respiratory mechanics during prehospital manual ventilation.
        Resuscitation. 2022; 177 (Epub ahead of print. PMID: 35690127): 55-62https://doi.org/10.1016/j.resuscitation.2022.06.003
        • Nichol G.
        • Leroux B.
        • Wang H.
        • et al.
        Trial of Continuous or Interrupted Chest Compressions during CPR.
        N Engl J Med. 2015; 373 (Epub 2015 Nov 9. PMID: 26550795): 2203-2214https://doi.org/10.1056/NEJMoa1509139
        • Aramendi E.
        • Lu Y.
        • Chang M.P.
        • et al.
        A novel technique to assess the quality of ventilation during pre-hospital cardiopulmonary resuscitation.
        Resuscitation. 2018; 132 (Epub 2018 Aug 16 PMID: 30121201): 41-46https://doi.org/10.1016/j.resuscitation.2018.08.016
        • Chang M.P.
        • Lu Y.
        • Leroux B.
        • et al.
        Association of ventilation with outcomes from out-of-hospital cardiac arrest.
        Resuscitation. 2019; 141 (Epub 2019 May 18. PMID: 31112744; PMCID: PMC6650372): 174-181https://doi.org/10.1016/j.resuscitation.2019.05.006
        • Wik L.
        • Kramer-Johansen J.
        • Myklebust H.
        • et al.
        Quality of cardiopulmonary resuscitation during out-of-hospital cardiac arrest.
        JAMA. 2005; 293 (PMID: 15657322): 299-304https://doi.org/10.1001/jama.293.3.299
        • Christenson J.
        • Andrusiek D.
        • Everson-Stewart S.
        • et al.
        Chest compression fraction determines survival in patients with out-of-hospital ventricular fibrillation.
        Circulation. 2009; 120 (Epub 2009 Sep 14. PMID: 19752324; PMCID: PMC2795631): 1241-1247https://doi.org/10.1161/CIRCULATIONAHA.109.852202
        • Nichol G.
        • Daya M.R.
        • Morrison L.J.
        • et al.
        Compression depth measured by accelerometer vs. outcome in patients with out-of-hospital cardiac arrest.
        Resuscitation. 2021; 167 (Epub 2021 Jul 29. PMID: 34331984): 95-104https://doi.org/10.1016/j.resuscitation.2021.07.013
        • Idris A.H.
        • Guffey D.
        • Aufderheide T.P.
        • et al.
        Relationship between chest compression rates and outcomes from cardiac arrest.
        Circulation. 2012; 125 (Epub 2012 May 23. PMID: 22623717; PMCID: PMC3388797): 3004-3012https://doi.org/10.1161/CIRCULATIONAHA.111.059535
        • Meaney P.A.
        • Bobrow B.J.
        • Mancini M.E.
        • et al.
        Cardiopulmonary resuscitation quality: [corrected] improving cardiac resuscitation outcomes both inside and outside the hospital: a consensus statement from the American Heart Association.
        Circulation. 2013; 128 (Epub 2013 Jun 25. Erratum in: Circulation. 2013 Aug 20;128(8):e120. Erratum in: Circulation. 2013 Nov 12;128(20):e408. PMID: 23801105): 417-435https://doi.org/10.1161/CIR.0b013e31829d8654