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Benefits of Manometer in Non-Invasive Ventilatory Support

Abstract
Abstract Introduction

Effective ventilation during cardiopulmonary resuscitation (CPR) is essential to reduce morbidity and mortality rates in cardiac arrest. Hyperventilation during CPR reduces the efficiency of compressions and coronary perfusion.

Problem

How could ventilation in CPR be optimized? The objective of this study was to evaluate non-invasive ventilator support using different devices.

Methods

The study compares the regularity and intensity of non-invasive ventilation during simulated, conventional CPR and ventilatory support using three distinct ventilation devices: a standard manual resuscitator, with and without airway pressure manometer, and an automatic transport ventilator. Student’s t-test was used to evaluate statistical differences between groups. P values <.05 were regarded as significant.

Results

Peak inspiratory pressure during ventilatory support and CPR was significantly increased in the group with manual resuscitator without manometer when compared with the manual resuscitator with manometer support (MS) group or automatic ventilator (AV) group.

Conclusion

The study recommends for ventilatory support the use of a manual resuscitator equipped with MS or AVs, due to the risk of reduction in coronary perfusion pressure and iatrogenic thoracic injury during hyperventilation found using manual resuscitator without manometer.

Lacerda RS , de Lima FCA , Bastos LP , Vinco AF , Schneider FBA , Coelho YL , Fernandes HGC , Bacalhau JMR , Bermudes IMS , da Silva CF , da Silva LP , Pezato R . Benefits of Manometer in Non-Invasive Ventilatory Support. Prehosp Disaster Med. 2017;32(6):615620.

Copyright
Corresponding author
Correspondence: Rogério Pezato, MD, PhD Rua dos Otonis, 700 Piso Superior Vila Clementino, 04025-002 São Paulo, SP, Brazil E-mail: pezatobau@ig.com.br
Footnotes
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Conflicts of interest/funding: This manuscript had technical support from Vent-Logos (Vitória, ES, Brazil), the company responsible for the manufacture of automatic ventilators. The authors declare no conflicts of interest.

Footnotes
References
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1. Dabrowska A, Telec W. [New guidelines of basic and advanced cardiopulmonary resuscitation and emergency cardiovascular care (ECC) American Heart Association (AHA)]. Wiad Lek. 2011;64(2):127-131.
2. O’Neill JF, Deakin CD. Do we hyperventilate cardiac arrest patients? Resuscitation. 2007;73:82-85.
3. Aufderheide TP, Sigurdsson G, Pirrallo RG, et al. Hyperventilation-induced hypotension during cardiopulmonary resuscitation. Circulation. 2004;109(16):1960-1965.
4. Schultz MJ, Haitsma JJ, Slutsky AS, Gajic O. What tidal volumes should be used in patients without acute lung injury? Anesthesiology. 2007;106:1226-1231.
5. Ho-Tai LM, Devitt JH, Noel AG, O’Donnell MP. Gas leak and gastric insufflation during controlled ventilation: face mask versus laryngeal mask airway. Can J Anaesth. 1998;45(3):206-211.
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Prehospital and Disaster Medicine
  • ISSN: 1049-023X
  • EISSN: 1945-1938
  • URL: /core/journals/prehospital-and-disaster-medicine
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