Tidal volume delivery during continuous chest compressions and sustained inflation.

OBJECTIVE

To determine the distending pressure needed to achieve sufficient tidal volume (VT) delivery during continuous chest compressions (CC) superimposed by sustained inflation (SI) (CC+SI).

DESIGN

Randomised animal/manikin trial.

SETTING

University laboratory.

SUBJECTS: Cadaver piglets/manikin.

INTERVENTIONS: SI distending pressures of 5, 10, 15, 20, 25 and 30 cm H2O were delivered in random order during CC+SI for 2 min each.

MAIN OUTCOME MEASURES: VT, gas flow and airway pressure. Spearman's r for distending pressure and VT.

RESULTS

Distending pressure and VT correlated in cadaver piglets (r=0.83, p<0.001), manikin (r=0.98, p<0.001) and combined data (r=0.49, p<0.001). VT was delivered during chest recoil during CC in both models. In cadaver piglets, a distending pressure ∼25 cm H2O was needed to achieve an adequate VT.

CONCLUSIONS

Chest recoil generates VT depending on an adequate distending pressure. This has previously been demonstrated in adult animals. A pressure of ∼25 cm H2O is needed to achieve an adequate VT delivery.