Advertisement
Editorial| Volume 184, 109696, March 2023

Measuring ventilation during out-of-hospital cardiac arrest: PART of the equation

Published:January 18, 2023DOI:https://doi.org/10.1016/j.resuscitation.2023.109696
Measuring ventilation during out-of-hospital cardiac arrest: PART of the equation
Previous ArticleEditorial Board
Next ArticleCan machine learning predict recurrent cardiac arrest?
      The optimal approach to ventilation during out-of-hospital cardiac arrest has long been debated. Early studies documented adverse hemodynamic consequences with high minute ventilation, while more recent ones highlight potentially ineffective ventilation in a substantial proportion of patients.
      • Aufderheide T.P.
      • Lurie K.G.
      Death by hyperventilation: a common and life-threatening problem during cardiopulmonary resuscitation.
      Crit Care Med. 2004; 32: S345-S351
      , 
      • Aufderheide T.P.
      • Sigurdsson G.
      • Pirrallo R.G.
      • et al.
      Hyperventilation-Induced Hypotension During Cardiopulmonary Resuscitation.
      Circulation. 2004; 109: 1960-1965
      , 
      • Bhandari S.
      • Coult J.
      • Counts C.R.
      • et al.
      Investigating the Airway Opening Index during cardiopulmonary resuscitation.
      Resuscitation. 2022; 178: 96-101
      , 
      • Lesimple A.
      • Fritz C.
      • Hutin A.
      • et al.
      A novel capnogram analysis to guide ventilation during cardiopulmonary resuscitation: clinical and experimental observations.
      Crit Care Lond Engl. 2022; 26: 287
      , 
      • Van Den Daele C.
      • Vanwulpen M.
      • Hachimi-Idrissi S.
      Chest compressions during ventilation in out-of-hospital cardiopulmonary resuscitation cause fragmentation of the airflow.
      Am J Emerg Med. 2021; 50: 455-458
      , 
      • Chang M.P.
      • Lu Y.
      • Leroux B.
      • et al.
      Association of ventilation with outcomes from out-of-hospital cardiac arrest.
      Resuscitation. 2019; 141: 174-181
      Both hypo- and hyperventilation may be associated with worse outcome, though studies are mixed.
      • Aufderheide T.P.
      • Lurie K.G.
      Death by hyperventilation: a common and life-threatening problem during cardiopulmonary resuscitation.
      Crit Care Med. 2004; 32: S345-S351
      , 
      • Aufderheide T.P.
      • Sigurdsson G.
      • Pirrallo R.G.
      • et al.
      Hyperventilation-Induced Hypotension During Cardiopulmonary Resuscitation.
      Circulation. 2004; 109: 1960-1965
      , 
      • Chang M.P.
      • Lu Y.
      • Leroux B.
      • et al.
      Association of ventilation with outcomes from out-of-hospital cardiac arrest.
      Resuscitation. 2019; 141: 174-181
      , 
      • Wang H.E.
      • Jaureguibeitia X.
      • Aramendi E.
      • et al.
      Airway strategy and ventilation rates in the pragmatic airway resuscitation trial.
      Resuscitation. 2022; 176: 80-87
      While a growing recognition of post-arrest pulmonary complications highlights a need to refine ventilation practices, a persistent challenge has been accurate measurement of ventilation parameters, including rate, volume, and pressures.
      • 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: 37-44
      , 

      Johnson NJ, Carlbom DJ, Gaieski DF. Ventilator management and respiratory care after cardiac arrest: oxygenation, ventilation, infection, and injury. 2018.

      , 
      • Shih J.A.
      • Robertson H.K.
      • Issa M.S.
      • et al.
      Acute respiratory distress syndrome after in-hospital cardiac arrest.
      Resuscitation. 2022; 177: 78-84
      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
      Register: Create an account
      Institutional Access: Sign in to ScienceDirect

      References

        • Aufderheide T.P.
        • Lurie K.G.
        Death by hyperventilation: a common and life-threatening problem during cardiopulmonary resuscitation.
        Crit Care Med. 2004; 32: S345-S351
        View in Article
        • Aufderheide T.P.
        • Sigurdsson G.
        • Pirrallo R.G.
        • et al.
        Hyperventilation-Induced Hypotension During Cardiopulmonary Resuscitation.
        Circulation. 2004; 109: 1960-1965
        View in Article
        • Bhandari S.
        • Coult J.
        • Counts C.R.
        • et al.
        Investigating the Airway Opening Index during cardiopulmonary resuscitation.
        Resuscitation. 2022; 178: 96-101
        View in Article
        • Lesimple A.
        • Fritz C.
        • Hutin A.
        • et al.
        A novel capnogram analysis to guide ventilation during cardiopulmonary resuscitation: clinical and experimental observations.
        Crit Care Lond Engl. 2022; 26: 287
        View in Article
        • Van Den Daele C.
        • Vanwulpen M.
        • Hachimi-Idrissi S.
        Chest compressions during ventilation in out-of-hospital cardiopulmonary resuscitation cause fragmentation of the airflow.
        Am J Emerg Med. 2021; 50: 455-458
        View in Article
        • Chang M.P.
        • Lu Y.
        • Leroux B.
        • et al.
        Association of ventilation with outcomes from out-of-hospital cardiac arrest.
        Resuscitation. 2019; 141: 174-181
        View in Article
        • Wang H.E.
        • Jaureguibeitia X.
        • Aramendi E.
        • et al.
        Airway strategy and ventilation rates in the pragmatic airway resuscitation trial.
        Resuscitation. 2022; 176: 80-87
        View in Article
        • 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: 37-44
        View in Article

      9. Johnson NJ, Carlbom DJ, Gaieski DF. Ventilator management and respiratory care after cardiac arrest: oxygenation, ventilation, infection, and injury. 2018.

        View in Article
        • Shih J.A.
        • Robertson H.K.
        • Issa M.S.
        • et al.
        Acute respiratory distress syndrome after in-hospital cardiac arrest.
        Resuscitation. 2022; 177: 78-84
        View in Article
        • Nassal M.M.J.
        • Jaureguibeitia X.
        • Aramendi E.
        • et al.
        Novel application of thoracic impedance to characterize ventilations during cardiopulmonary resuscitation in the pragmatic airway resuscitation trial.
        Resuscitation. 2021; 168: 58-64
        View in Article
        • Yang B.Y.
        • Blackwood J.E.
        • Shin J.
        • et al.
        A pilot evaluation of respiratory mechanics during prehospital manual ventilation.
        Resuscitation. 2022; 177: 55-62
        View in Article
        • Grieco D.L.
        • Brochard J.L.
        • Drouet A.
        • et al.
        Intrathoracic Airway Closure Impacts CO2 Signal and Delivered Ventilation during Cardiopulmonary Resuscitation.
        Am J Respir Crit Care Med. 2019; 199: 728-737
        View in Article
        • Abrahamowicz A.A.
        • Counts C.R.
        • Danielson K.R.
        • et al.
        The association between arterial-end-tidal carbon dioxide difference and outcomes after out-of-hospital cardiac arrest.
        Resuscitation. 2022; 181: 3-9
        View in Article
        • Wang H.
        • Jaureguibeitia X.
        • Aramendi E.
        • et al.
        Methods for calculating ventilation rates during resuscitation from out-of-hospital cardiac arrest.
        Resuscitation. 2022; 109679
        View in Article

      Article info

      Publication history

      Published online: January 18, 2023
      Accepted: January 10, 2023
      Received: January 9, 2023

      Identification

      DOI: https://doi.org/10.1016/j.resuscitation.2023.109696

      Copyright

      © 2023 Elsevier B.V. All rights reserved.

      ScienceDirect

      Access this article on ScienceDirect

      The content on this site is intended for healthcare professionals.


      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the Cookie Preference Center for this site.
      Copyright © 2023 Elsevier Inc. except certain content provided by third parties.


      RELX