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 10:1, 12:1, and 15:1, 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 10:1, 12:1, and 15:1) 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 10:1, 12:1, and 15:1, respectively (p<0.0001). CONCLUSION: Compression to ventilation ratio of 12:1 resulted in a significantly appropriate ventilation rate, compared with the ratio of 10:1 or 15:1. Pre-set compression to ventilation ratio of 12:1 seems to be a novel method for delivery of an appropriate number of ventilations during CPR after establishment of an advanced airway.