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Ding B, Pan C, Pang J, Wang J, Li K, Xu F, Chen Y. Effects of Chest Compression on Ventilation Quality during Cardiopulmonary Resuscitation. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-4. [PMID: 38082754 DOI: 10.1109/embc40787.2023.10340259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Ventilation is an important part of cardiopulmonary resuscitation (CPR). The advanced airway mode and 30:2 mode are used for intubated and non-intubated patients, respectively. It is debatable that passive produced by 30 compressions can provide adequate tidal volume for 30:2 mode. In addition, the fragmented ventilation caused by continuous compression may result in ineffective ventilation. In the study, one pig was anaesthetized and intubated for 2 CPRs. Continuous chest compressions with ventilation and continuous chest compressions without mechanical ventilation were performed in 2 CPRs, respectively. Three 10-minute data segments including a period of normal ventilation (V segment), a period of only compressions without ventilation (C segment), and a period of compressions with ventilation (C-V segment) were used to analyze peek flow (PF), peek pressure (PP) and tidal volume. All the data was presented as mean ± standard deviation. Chest compression resulted in 14.90% increase in mean PP (2401.40 ± 94.75 Pa vs 2822.06 ± 291.10 Pa, p<0.05), 81.46% increase in average PF (319.58 ± 56.93 ml/s vs 579.92 ± 80.27 ml/s, p<0.05). The mean tidal volumes for C segment, V segment and C-V segment were 189.13 ml, 514.72 ml, and 429.26ml, respectively. Continuous compressions reduced the accumulative tidal volume, but when five compressions were made in one inspiratory phase, there is almost no loss of tidal volume (510.86 ± 47.24 ml vs 514.72 ± 29.25 ml, p<0.05). The study suggested the ventilator without feedback regulation might reduce the peek pressure during CPR and 5 compressions in 2 s inspiratory phase provided higher tidal volume.Clinical Relevance- This study shows that 150 chest compressions per minute provided greater tidal volume than 100 and 120 compressions per minute; continuous chest compressions could also provide a certain amount of oxygen supply.
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Pritchard WF, Karanian JW, Jung C, Bakhutashvili I, Reed SL, Starost MF, Froelke BR, Barnes TR, Stevenson D, Mendoza A, Eckstein DJ, Wood BJ, Walsh BK, Mannes AJ. In-line miniature 3D-printed pressure-cycled ventilator maintains respiratory homeostasis in swine with induced acute pulmonary injury. Sci Transl Med 2022; 14:eabm8351. [PMID: 36223450 PMCID: PMC9884101 DOI: 10.1126/scitranslmed.abm8351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The COVID-19 pandemic demonstrated the need for inexpensive, easy-to-use, rapidly mass-produced resuscitation devices that could be quickly distributed in areas of critical need. In-line miniature ventilators based on principles of fluidics ventilate patients by automatically oscillating between forced inspiration and assisted expiration as airway pressure changes, requiring only a continuous supply of pressurized oxygen. Here, we designed three miniature ventilator models to operate in specific pressure ranges along a continuum of clinical lung injury (mild, moderate, and severe injury). Three-dimensional (3D)-printed prototype devices evaluated in a lung simulator generated airway pressures, tidal volumes, and minute ventilation within the targeted range for the state of lung disease each was designed to support. In testing in domestic swine before and after induction of pulmonary injury, the ventilators for mild and moderate injury met the design criteria when matched with the appropriate degree of lung injury. Although the ventilator for severe injury provided the specified design pressures, respiratory rate was elevated with reduced minute ventilation, a result of lung compliance below design parameters. Respiratory rate reflected how well each ventilator matched the injury state of the lungs and could guide selection of ventilator models in clinical use. This simple device could help mitigate shortages of conventional ventilators during pandemics and other disasters requiring rapid access to advanced airway management, or in transport applications for hands-free ventilation.
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Affiliation(s)
- William F. Pritchard
- Center for Interventional Oncology, Radiology and Imaging Sciences, NIH Clinical Center, National Institutes of Health; Bethesda, MD 20892, USA.,Corresponding author.
| | - John W. Karanian
- Center for Interventional Oncology, Radiology and Imaging Sciences, NIH Clinical Center, National Institutes of Health; Bethesda, MD 20892, USA
| | | | - Ivane Bakhutashvili
- Center for Interventional Oncology, Radiology and Imaging Sciences, NIH Clinical Center, National Institutes of Health; Bethesda, MD 20892, USA
| | - Sheridan L. Reed
- Center for Interventional Oncology, Radiology and Imaging Sciences, NIH Clinical Center, National Institutes of Health; Bethesda, MD 20892, USA
| | - Matthew F. Starost
- Division of Veterinary Resources, National Institutes of Health; Bethesda, MD 20892, USA
| | - Brian R. Froelke
- fluidIQ, Inc; Lewes, DE 19958, USA.,Interstate Disaster Medical Collaborative; St. Louis, MO 63141, USA
| | | | | | | | - David J. Eckstein
- Office of Clinical Research, Office of the Director, National Institutes of Health; Bethesda, MD 20892, USA
| | - Bradford J. Wood
- Center for Interventional Oncology, Radiology and Imaging Sciences, NIH Clinical Center, National Institutes of Health; Bethesda, MD 20892, USA.,National Cancer Institute, National Institutes of Health; Bethesda, MD 20892, USA
| | - Brian K. Walsh
- fluidIQ, Inc; Lewes, DE 19958, USA.,Department of Respiratory Care, School of Health Professions, University of Texas Medical Branch; Galveston, TX 77555, USA
| | - Andrew J. Mannes
- Department of Perioperative Medicine, NIH Clinical Center, National Institutes of Health; Bethesda, MD 20892, USA
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