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Bag-Valve-Mask versus Laryngeal Mask Airway Ventilation in Cardiopulmonary Resuscitation with Continuous Compressions: A Simulation Study

Published online by Cambridge University Press:  01 February 2021

Zerrin Defne Dundar Open the ORCID record for Zerrin Defne Dundar [Opens in a new window] ,
Mustafa Kursat Ayranci Open the ORCID record for Mustafa Kursat Ayranci [Opens in a new window] ,
Sedat Kocak  and
Abdullah Sadik Girisgin
Zerrin Defne Dundar*
Affiliation:
Emergency Medicine Department, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
Mustafa Kursat Ayranci
Affiliation:
Emergency Medicine Department, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
Sedat Kocak
Affiliation:
Emergency Medicine Department, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
Abdullah Sadik Girisgin
Affiliation:
Emergency Medicine Department, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
*
Correspondence: Zerrin Defne Dundar, MD, Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi, Acil Tıp ABD 42080 Meram/Konya, Turkey, E-mail: zerdef@hotmail.com
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Abstract

Introduction:

The 2017 International Liaison Committee on Resuscitation (ILCOR) guideline recommends that Emergency Medical Service (EMS) providers can perform cardiopulmonary resuscitation (CPR) with synchronous or asynchronous ventilation until an advanced airway has been placed. In the current literature, limited data on CPR performed with continuous compressions and asynchronous ventilation with bag-valve-mask (BVM) are available.

Study Objective:

In this study, researchers aimed to compare the effectiveness of asynchronous BVM and laryngeal mask airway (LMA) ventilation during CPR with continuous chest compressions.

Methods:

Emergency medicine residents and interns were included in the study. The participants were randomly assigned to resuscitation teams with two rescuers. The cross-over simulation study was conducted on two CPR scenarios: asynchronous ventilation via BVM during a continuous chest compression and asynchronous ventilation via LMA during a continuous chest compression in cardiac arrest patient with asystole. The primary endpoints were the ventilation-related measurements.

Results:

A total of 92 volunteers were included in the study and 46 CPRs were performed in each group. The mean rate of ventilations of the LMA group was significantly higher than that of the BVM group (13.7 [11.7-15.7] versus 8.9 [7.5-10.3] breaths/minute; P <.001). The mean volume of ventilations of the LMA group was significantly higher than that of the BVM group (358.4 [342.3-374.4] ml versus 321.5 [303.9-339.0] ml; P = .002). The mean minute ventilation volume of the LMA group was significantly higher than that of the BVM group (4.88 [4.15-5.61] versus 2.99 [2.41-3.57] L/minute; P <.001). Ventilations exceeding the maximum volume limit occurred in two (4.3%) CPRs in the BVM group and in 11 (23.9%) CPRs in the LMA group (P = .008).

Conclusion:

The results of this study show that asynchronous BVM ventilation with continuous chest compressions is a reliable and effective strategy during CPR under simulation conditions. The clinical impact of these findings in actual cardiac arrest patients should be evaluated with further studies at real-life scenes.

Keywords

bag-valve-maskcardiopulmonary resuscitationcontinuous compressionlaryngeal mask airwayventilation
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 36 , Issue 2 , April 2021 , pp. 189 - 194
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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References

Kleinman, ME, Brennan, EE, Goldberger, ZD, et al. Part 5: adult basic life support and cardiopulmonary resuscitation quality: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 Suppl 2):S414–435.CrossRefGoogle ScholarPubMed
Monsieurs, KG, Nolan, JP, Bossaert, LL, et al. European Resuscitation Council guidelines for resuscitation 2015: Section 1. Executive summary. Resuscitation. 2015;95:1–80.CrossRefGoogle ScholarPubMed
McMullan, J, Gerecht, R, Bonomo, J, et al. Airway management and out-of-hospital cardiac arrest outcome in the CARES registry. Resuscitation. 2014;85(5):617–622.CrossRefGoogle ScholarPubMed
Chang, MP, Lu, Y, Leroux, B, et al. Association of ventilation with outcomes from out-of-hospital cardiac arrest. Resuscitation. 2019;141:174–181.CrossRefGoogle ScholarPubMed
Olasveengen, TM, de Caen, AR, Mancini, ME, et al. 2017 International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations summary. Resuscitation. 2017;121:201–214.CrossRefGoogle ScholarPubMed
Soar, J, Maconochie, I, Wyckoff, MH, et al. 2019 International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations: summary. Circulation. 2019;140(24):e826–880.Google ScholarPubMed
Sulzgruber, P, Datler, P, Sterz, F, et al. The impact of airway strategy on the patient outcome after out-of-hospital cardiac arrest: a propensity score matched analysis. Eur Heart J Acute Cardiovasc Care. 2018;7(5):423–431.CrossRefGoogle ScholarPubMed
Hasegawa, K, Hiraide, A, Chang, Y, Brown, DF. Association of prehospital advanced airway management with neurologic outcome and survival in patients with out-of-hospital cardiac arrest. JAMA. 2013;309(3):257–266.CrossRefGoogle ScholarPubMed
Jeong, S, Ahn, KO, Shin, SD. The role of prehospital advanced airway management on outcomes for out-of-hospital cardiac arrest patients: a meta-analysis. Am J Emerg Med. 2016;34(11):2101–2106.CrossRefGoogle ScholarPubMed
Jabre, P, Penaloza, A, Pinero, D, et al. Effect of bag-mask ventilation vs endotracheal intubation during cardiopulmonary resuscitation on neurological outcome after out-of-hospital cardiorespiratory arrest: a randomized clinical trial. JAMA. 2018;319(8):779–787.CrossRefGoogle ScholarPubMed
Liu, YC, Qi, YM, Zhang, H, Walline, J, Zhu, HD. A survey of ventilation strategies during cardiopulmonary resuscitation. World J Emerg Med. 2019;10(4):222–227.CrossRefGoogle ScholarPubMed
Nichol, G, Leroux, B, Wang, H, et al. Trial of continuous or interrupted chest compressions during CPR. N Engl J Med. 2015;373(23):2203–2214.CrossRefGoogle ScholarPubMed
Manrique, G, García, M, Fernández, SN, et al. Comparison between synchronized and non-synchronized ventilation and between guided and non-guided chest compressions during resuscitation in a pediatric animal model after asphyxial cardiac arrest. PLoS One. 2019;14(7):e0219660.CrossRefGoogle Scholar
Kramer-Johansen, J, Wik, L, Steen, PA. Advanced cardiac life support before and after tracheal intubation – direct measurements of quality. Resuscitation. 2006;68(1):61–69.CrossRefGoogle ScholarPubMed
Sall, FS, De Luca, A, Pazart, L, Pugin, A, Capellier, G, Khoury, A. To intubate or not: ventilation is the question. A manikin-based observational study. BMJ Open Respir Res. 2018;5(1):e000261.CrossRefGoogle ScholarPubMed
Nikolla, DA, Kramer, BJ, Carlson, JN. A cross-over trial comparing conventional to compression-adjusted ventilations with metronome-guided compressions. Prehosp Disaster Med. 2019;34(2):220–223.CrossRefGoogle ScholarPubMed
Newell, C, Grier, S, Soar, J. Airway and ventilation management during cardiopulmonary resuscitation and after successful resuscitation. Crit Care. 2018;22(1):190.CrossRefGoogle ScholarPubMed
Serpa Neto, A, Cardoso, SO, Manetta, JA, et al. Association between use of lung-protective ventilation with lower tidal volumes and clinical outcomes among patients without acute respiratory distress syndrome: a meta-analysis. JAMA. 2012;308(16):1651–1659.CrossRefGoogle ScholarPubMed
Ruemmler, R, Ziebart, A, Moellmann, C, et al. Ultra-low tidal volume ventilation - a novel and effective ventilation strategy during experimental cardiopulmonary resuscitation. Resuscitation. 2018;132:56–62.CrossRefGoogle ScholarPubMed
Cierniak, M, Maksymowicz, M, Borkowska, N, Gaszyński, T. Comparison of ventilation effectiveness of the bag valve mask and the LMA Air-Q SP in nurses during simulated CPR. Pol Merkur Lekarski. 2018;44(263):223–226.Google ScholarPubMed