Title | Ventilation during resuscitation efforts for out-of-hospital primary cardiac arrest. |
Publication Type | Journal Article |
Year of Publication | 2009 |
Authors | Bobrow BJ, Ewy GA |
Journal | Curr Opin Crit Care |
Volume | 15 |
Issue | 3 |
Pagination | 228-33 |
Date Published | 2009 Jun |
ISSN Number | 1531-7072 |
Keywords | Cardiopulmonary Resuscitation, Cerebrovascular Circulation, Emergency Medical Services, Heart Arrest, Humans, Respiration, Artificial |
Abstract | PURPOSE OF REVIEW: To discuss recent findings surrounding the role of ventilation during cardiopulmonary resuscitation for individuals with out-of-hospital primary cardiac arrest. RECENT FINDINGS: Active assisted ventilation during primary cardiac arrest may not always be beneficial and, in some circumstances, may lead to worse outcomes. By interrupting chest compressions and thereby decreasing vital organ perfusion, rescue breathing may be deleterious. In addition to the time required to administer breaths, the delay due to the insertion of advanced airways, even by well trained individuals, is often extensive. Furthermore, once intubation is completed, excessive hyperventilation occurs frequently, even by recently trained medical providers. Although most experts agree that excessive ventilation is harmful during out-of-hospital cardiac resuscitation, the optimal rate, tidal volume, timing, and technique of ventilation is still unknown. There is increasing evidence that, in patients with witnessed arrests and a shockable rhythm, the optimal form of ventilation is passive oxygen insufflation. SUMMARY: Assisted ventilation during the initial provision of cardiopulmonary resuscitation is less important than previously believed. It is hypothesized that, by training prehospital medical providers to utilize passive oxygen insufflation for individuals with primary cardiac arrest, critical organ perfusion will increase and, therefore, survival after out-of-hospital cardiac arrest will improve. |
Alternate Journal | Curr Opin Crit Care |
PubMed ID | 19469024 |