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Tidal volume delivery during continuous chest compressions and sustained inflation
  1. A L Solevåg1,2,3,
  2. T-F Lee1,2,
  3. M Lu1,2,
  4. G M Schmölzer1,2,
  5. P-Y Cheung1,2
  1. 1Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Alberta, Canada
  2. 2Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
  3. 3Department of Pediatric and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway
  1. Correspondence to Dr Anne Lee Solevåg, Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, 10240 Kingsway Avenue NW, Edmonton, Alberta, Canada T5H 3V9; a.l.solevag{at}medisin.uio.no

Abstract

Objective To determine the distending pressure needed to achieve sufficient tidal volume (VT) delivery during continuous chest compressions (CC) superimposed by sustained inflation (SI) (CC+SI).

Design Randomised animal/manikin trial.

Setting University laboratory.

Subjects Cadaver piglets/manikin.

Interventions SI distending pressures of 5, 10, 15, 20, 25 and 30 cm H2O were delivered in random order during CC+SI for 2 min each.

Main outcome measures VT, gas flow and airway pressure. Spearman's r for distending pressure and VT.

Results Distending pressure and VT correlated in cadaver piglets (r=0.83, p<0.001), manikin (r=0.98, p<0.001) and combined data (r=0.49, p<0.001). VT was delivered during chest recoil during CC in both models. In cadaver piglets, a distending pressure ∼25 cm H2O was needed to achieve an adequate VT.

Conclusions Chest recoil generates VT depending on an adequate distending pressure. This has previously been demonstrated in adult animals. A pressure of ∼25 cm H2O is needed to achieve an adequate VT delivery.

  • Neonatology
  • Resuscitation

https://doi.org/10.1136/archdischild-2016-311043

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    Footnotes

    • Contributors Conception and design: ALS, T-FL, ML, PYC, GMS. Collection and assembly of data: ALS, T-FL, ML, P-YC, GMS. Drafting of the article: ALS, GMS, P-YC. Critical revision of the article for important intellectual content: ALS, T-FL, ML, P-YC, GMS. Final approval of the article: ALS, T-FL, ML, P-YC, GMS.

    • Funding Canadian Institutes of Health Research, 10.13039/501100000024, MOP-CIA-299111.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.