Comparison of partial pressure of oxygen between compression-only CPR and standard CPR in simulated adult cardiac arrest - A manikin-based clinical modelling

模拟成人心脏骤停中单纯胸外按压CPR与标准CPR氧分压的比较——基于人体模型的临床建模

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Abstract

BACKGROUND AND AIMS: Compression-only cardiopulmonary resuscitation (CPR) has been shown to be as effective as conventional CPR, and oxygen supplementation during compression-only CPR may be beneficial. The study aimed to compare the arterial oxygen levels achieved while supplementing oxygen through high flow nasal cannula (HFNC) during compression-only CPR and bag-mask ventilation (BMV) during conventional CPR in simulated cardiac arrest scenarios on a high-fidelity simulator. METHODS: The study included a simulated cardiac arrest created on a human patient simulator (HPS). The simulation included two sets of scenarios. In Simulation A, cardiac arrest was simulated on HPS, and compression-only CPR was provided by AutoPulse, and oxygen supplementation was provided using HFNC. In Simulation B, chest compression was provided by AutoPulse, and BMV was supplemented with oxygen at 15 L/min at a compression-to-ventilation ratio of 30:2. Both simulation scenarios were evaluated for three different starting PaO(2) values: 100 mmHg, 80 mmHg, and 60 mmHg. The change in PaO(2) and PAO(2) values was recorded every minute for 6 minutes. Statistical analysis was conducted using SPSS Statistics (Version 24.0; IBM, Armonk, NY), and P < 0.05 was considered statistically significant. RESULTS: In Simulation A, at a starting PaO(2) of 100 mmHg, there was an increase in the PaO(2) at the 2(nd) minute, which was sustained till the 6(th) minute. PaO(2) values were persistently higher at all time points as compared to Simulation B (P < 0.001). At a starting PaO(2) of 80 mmHg, there was no change in PaO(2) in Simulation A as compared to a sustained fall in Simulation B (P < 0.001). At the starting PaO(2) of 60 mmHg, a decrease in PaO(2) was observed in both Simulation A and Simulation B (P = 0.57). CONCLUSION: In a simulated setting, compression-only CPR with HFNC results in better PaO(2) levels compared to conventional CPR with BMV.

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