A Novel Method for Delivery of an Appropriate Rate of Ventilation During Cardiopulmonary Resuscitation with a Placement of Advanced airway: Setting a Compression Numbers to Ventilation Ratio

ABSTRACT

PURPOSE: Hyperventilation during cardiopulmonary resuscitation (CPR) is common and can be detrimental to survival. We designed a method for delivery of an appropriate rate of ventilation during CPR by setting a compression numbers to ventilation ratio. METHODS: We conducted a virtual simulation trial using 12 randomly sorted actual CPR video files. Participants provided ventilation using a self-inflating bag while watching one minute of CPR video clips utilizing pre-set compression to ventilation ratios of 101, 121, and 151, respectively. Ventilation rates per minute were manually calculated and analyzed. RESULTS: Eight medical doctors and eight emergency medical technician students were included. Among the three groups, significant different mean (S.D) ventilation rate per min (compression to ventilation ratio were 101, 121, and 151) was (9.9 (1.3) vs. 8.8 (1.0) vs. 7.2 (0.8), respectively; p<0.0001). Proportion of the number of appropriately delivered ventilations was 62.5%, 89.6%, and 38.0% for compression to ventilation ratios of 101, 121, and 151, respectively (p<0.0001). CONCLUSION: Compression to ventilation ratio of 121 resulted in a significantly appropriate ventilation rate, compared with the ratio of 101 or 151. Pre-set compression to ventilation ratio of 121 seems to be a novel method for delivery of an appropriate number of ventilations during CPR after establishment of an advanced airway.