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The objective of this study is to determine whether healthcare professionals trained in CPR can deliver more effective ventilations during CPR using the Handivent, a novel turbine-driven ventilator as compared to bag-valve-mask ventilations, using a manikin model. The investigators believe the Handivent will deliver a more accurate respiratory rate and tidal volume, with lower intrathoracic pressure during CPR.
Previous studies have shown that increased respiratory rate during CPR inversely correlates with blood pressure. Higher respiratory rates increase intrathoracic pressure, which in turn decreases venous return to the heart.
In one previous study, the authors looked at 3 groups of 7 pigs, ventilated at 12 (100% O2), 30 (100%), and 30 (5% CO2, 95% 02) breaths per minute during cardiac arrest, and showed increased mortality with increasing respiratory rate. Survival rates were 6/7, 1/7, and 1/7 respectively. The results of this study led to changing the CPR guidelines in 2005 to include fewer ventilations.
The authors also observed 13 cases of CPR in the field and noted EMS personnel delivered breaths at an average of 32 bpm.
In 2012, a similar study to the current study under proposal compared a pressure-limited, pneumatically driven ventilator to bag-valve-mask in simulated CPR, using medical student volunteers. That study did not show a significant difference in tidal volumes; however, they did not record respiratory rates or mean intrathoracic pressures. Furthermore, that ventilator was pneumatically -driven and pressure limited, whereas the ventilator we propose to study is turbine-driven and can be volume/time triggered.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CPR simulation | Experimental | CPR simulation with and without ventilator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Handivent Ventilator | Device | CPR with use of a turbine-driven ventilator (Handivent) |
|
| Measure | Description | Time Frame |
|---|---|---|
| Respiratory rate | The study will measure the respiratory rate delivered during the 8-minute CPR scenario | RR will be the average RR during the CPR simulation, which is 8-minutes in duration. |
| Measure | Description | Time Frame |
|---|---|---|
| Tidal volume | The study will measure the tidal volume delivered during the 8-minute CPR scenario | Average Vt during CPR simulation, which is 8 minutes in duration |
| Peak Inspiratory pressure | the study will measure the peak inspiratory pressure delivered during the 8-minute CPR scenario |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Scott Allen, MD | University of Utah | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28807986 | Derived | Allen SG, Brewer L, Gillis ES, Pace NL, Sakata DJ, Orr JA. A Turbine-Driven Ventilator Improves Adherence to Advanced Cardiac Life Support Guidelines During a Cardiopulmonary Resuscitation Simulation. Respir Care. 2017 Sep;62(9):1166-1170. doi: 10.4187/respcare.05368. Epub 2017 Aug 14. |
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| ID | Term |
|---|---|
| D006323 | Heart Arrest |
| D006985 | Hyperventilation |
| ID | Term |
|---|---|
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
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| Average PIP delivered during CPR simulation, which is 8 minutes in duration. |
| D012818 | Signs and Symptoms, Respiratory |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |