Real-time tidal volume feedback guides optimal ventilation during simulated CPR - 19/04/17

Doi : 10.1016/j.ajem.2016.10.085

Kyoung Min You, MD ^a,^{^{1
Kyoung Min You and Chiwon Lee contributed equally to the study as first authors.}}, Chiwon Lee, PhD ^b,^{^{1
Kyoung Min You and Chiwon Lee contributed equally to the study as first authors.}}, Woon Yong Kwon, MD, PhD ^c,^d,^{^⁎} , Jung Chan Lee, PhD ^a,^b,^e,^{^⁎⁎} , Gil Joon Suh, MD, PhD ^c,^d, Kyung Su Kim, MD, PhD ^d, Min Ji Park, MD ^d, Sungwan Kim, PhD ^a,^b,^e
^a Department of Biomedical Engineering, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
^b Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
^c Department of Emergency Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
^d Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
^e Department of Biomedical Engineering, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea

^⁎Correspondence to: W.Y. Kwon, Department of Emergency Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. Tel.: +82 2 2072 0326; fax: +82 2 3672 8871.Department of Emergency MedicineSeoul National University College of Medicine103 Daehak-ro, Jongno-guSeoul03080Republic of Korea^⁎⁎Correspondence to: J.C. Lee, Department of Biomedical Engineering, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. Tel.: +82 2 740 8573; fax: +82 2 745 7870.Department of Biomedical EngineeringSeoul National University College of Medicine103 Daehak-ro, Jongno-guSeoul03080Republic of Korea

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.

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Plan

Proportion of optimal ventilation per person

Distribution of hypoventilation, optimal ventilation, and hyperventilation

Proportion of hyperventilation

Discussion

Conclusions

Conflict of interest

☆	Funding: This work was supported by the grant of the Seoul National University Hospital Research Fund (grant 0320150240).

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Vol 35 - N° 2

P. 292-298 - février 2017 Retour au numéro

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Real-time tidal volume feedback guides optimal ventilation during simulated CPR - 19/04/17

Abstract

Purpose

Basic procedures

Main findings

Principal conclusions

Plan

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