Real-time tidal volume feedback guides optimal ventilation during simulated CPR.

Abstract

PURPOSE:

We performed this study to investigate whether real-time tidal volume feedback increases optimal ventilation and decreases hyperventilation during manikin-simulated cardiopulmonary resuscitation (CPR).

BASIC PROCEDURES:

We developed a new real-time tidal volume monitoring device (TVD) which estimated tidal volume in real time using a magnetic flowmeter. The TVD was validated with a volume-controlled mechanical ventilator with various tidal volumes. We conducted a randomized, crossover, manikin-simulation study in which 14 participants were randomly divided into a control (without tidal volume feedback, n = 7) and a TVD group (with real-time tidal volume feedback, n = 7) and underwent manikin simulation. The optimal ventilation was defined as 420-490 mL of tidal volumes for a 70-kg adult manikin. After 2 weeks of the washout period, the simulation was repeated via the participants' crossover.

MAIN FINDINGS:

In the validation study, 97.6% and 100% of the difference ratios in tidal volumes between the mechanical ventilator and TVD were within ±1.5% and ±2.5%, respectively. During manikin-simulated CPR, TVD use increased the proportion of optimal ventilation per person. Its median values (range) of the control group and the TVD group were 37.5% (0.0-65.0) and 87.5% (65.0-100.0), respectively, P < .001). TVD use also decreased hyperventilation. The proportions of hyperventilation in the control group and the TVD group were 25.0% vs 8.9%, respectively (P < .001).

PRINCIPAL CONCLUSIONS:

Real-time tidal volume feedback using the new TVD guided the rescuers to provide optimal ventilation and to avoid hyperventilation during manikin-simulated CPR.

• Authors: Kyoung Min You, Chiwon Lee, Woon Yong Kwon, Jung Chan Lee, Gil Joon Suh, Kyung Su Kim, Min Ji Park, Sungwan Kim
• Journal: The American journal of emergency medicine (Am J Emerg Med) Vol. 35 Issue 2 Pg. 292-298 (Feb 2017) ISSN: 1532-8171 [Electronic] United States
• PMID: 27887820 (Publication Type: Journal Article)
• Copyright: Copyright © 2016 Elsevier Inc. All rights reserved.

Topics

• Cardiopulmonary Resuscitation (methods, standards)
• Computer Systems
• Cross-Over Studies
• Feedback, Physiological
• Female
• Humans
• Hyperventilation (complications, prevention & control)
• Male
• Manikins
• Respiration, Artificial (methods, standards)
• Simulation Training (methods)
• Tidal Volume