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document
[ Study of setting of ventilator volume tidal and airway pressure alarm threshold with continuous extra-sternum heart compression in cardiopulmonary resuscitation ] . OBJECTIVE To investigate the setting of ventilator volume tidal ( VT ) and airway pressure alarm threshold during cardiopulmonary resuscitation ( CPR ) by continuous extra-sternum heart compression . METHODS Forty cases with respiration and cardiac arrest in the department of critical care medicine were randomly divided into low VT ventilation group and conventional VT group . Both groups were given the volume control mode . In the low VT ventilation group , VT was set on 6 - 7 ml/kg , and high pressure alarm threshold was adjusted to 60 cm H2O by the conventional 40 cm H2O during CPR . In the conventional VT group , VT and high pressure alarm threshold were set at 8 - 12 ml/kg and 40 cm H2O , respectively . Real-time actual VT , peak inspiratory pressure ( PIP ) , and arterial blood gas test , blood lactic acid at 10 minutes and 30 minutes after CPR were observed . RESULTS At 10 minutes after CPR , in the low VT ventilation group , arterial blood pH , arterial partial pressure of oxygen ( PaO2 ) , arterial partial pressure of carbon dioxide ( PaCO2 ) , HCO3 ( - ) , arterial oxygen saturation ( SaO2 ) and blood lactic acid were better as compared with those in the conventional VT ventilation group ( pH : 7.21±0.09 vs. 7.13±0.07 , PaO2 : 45.35±5.92 mm Hg vs. 40.70±4.70 mm Hg , PaCO2 : 57.10±7.59 mm Hg vs. 61.60±5.47 mm Hg , HCO3 ( - ) : 18.50±3.50 mmol/L vs. 14.75±2.65 mmol/L , SaO2 : 0.796±0.069 vs. 0.699±0.066 , blood lactic acid : 7.07±1.60 mmol/L vs. 8.13±1.56 mmol/L , all P < 0.05 ) . The success rate of resuscitation in the low VT ventilation group was higher than that of the conventional VT ventilation group ( 45 % vs. 15 % , P < 0.05 ) , and PIP ( cm H2O ) of low VT ventilation group was lower than that of the conventional VT group ( 37.25±7.99 cm H2O vs. 42.70±7.40 cm H2O , P < 0.05 ) . In all the patients in both groups barotrauma did not occur . CONCLUSION The strategy of low ventilator VT ( 6 - 7 ml/kg ) with appropriate elevation of airway pressure alarm threshold was better than that of conventional ventilation setting , with no increase in incidence of barotraumas during CPR .
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Intervention_Physical
setting of ventilator volume tidal
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Intervention_Other
and
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Intervention_Physical
airway pressure alarm threshold
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Intervention_Physical
continuous extra-sternum heart compression
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Intervention_Physical
ventilator volume tidal ( VT )
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Intervention_Other
and
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Intervention_Physical
airway pressure alarm threshold
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Intervention_Physical
cardiopulmonary resuscitation ( CPR
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Intervention_Physical
continuous extra-sternum heart compression
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Intervention_Physical
low VT ventilation group
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Intervention_Other
and
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Intervention_Physical
conventional VT group
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Intervention_Physical
low VT ventilation
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Intervention_Other
conventional
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Intervention_Physical
conventional VT group
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Intervention_Physical
low VT ventilation
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Intervention_Physical
conventional VT ventilation
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Outcome_Other
ventilator
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Outcome_Physical
Real-time actual VT , peak inspiratory pressure ( PIP ) , and arterial blood gas test , blood lactic acid at 10 minutes and 30 minutes after CPR
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Outcome_Physical
arterial blood pH , arterial partial pressure of oxygen ( PaO2 ) , arterial partial pressure of carbon dioxide ( PaCO2 ) , HCO3 ( - ) , arterial oxygen saturation ( SaO2 ) and blood lactic acid
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Participant_Condition
cardiopulmonary resuscitation
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Participant_Condition
respiration and cardiac arrest