The effect of ventilation rate on outcome in adults receiving cardiopulmonary resuscitation

RESUSCITATION

卷:138

Article

Vissers, G.^1,2  Duchatelet, C.^3,4  Huybrechts, S. A.^1,2  Wouters, K.^1,5  Hachimi-Idrissi, S.^3,4  Monsieurs, K. G.^1,2 

[1] Univ Antwerp, Fac Med & Hlth Sci, Antwerp, Belgium

[2] Antwerp Univ Hosp, Dept Emergency Med, Wilrijkstr 10, B-2650 Edegem, Belgium

[3] Univ Ghent, Fac Med, Ghent, Belgium

[4] Ghent Univ Hosp, Dept Emergency Med, Ghent, Belgium

[5] Antwerp Univ Hosp, Sci Coordinat & Biostat, Edegem, Belgium

关键词: Cardiac arrest;    CPR;    Neurological outcome;    Resuscitation;    ROSC;    Tracheal pressure measurements;    Ventilation rate;   

DOI  :  10.1016/j.resuscitation.2019.03.037

来源: Elsevier

【 摘 要 】

Aim:To investigate whether a ventilation rate <= 10 breaths min(-1) in adult cardiac arrest patients treated with tracheal intubation and chest compressions in a prehospital setting is associated with improved Return of Spontaneous Circulation (ROSC), survival to hospital discharge and one-year survival with favourable neurological outcome, compared to a ventilation rate >10 breaths min(-1). Methods: In this retrospective study, prospectively acquired data were analysed. Ventilation rates were measured with end-tidal CO, and ventilation pressures. Analyses were corrected for age, sex, compression rate, compression depth, initial heart rhythm and cause of cardiac arrest. Results: 337 of 652 patients met the inclusion criteria. Hyperventilation was common, with 85% of the patients ventilated >10 breaths min(-1). The mean ventilation rate was 15.3 breaths min(-1). The corrected odds ratio (OR) of ventilating >10 breaths min(-1) for achieving ROSC was 0.91 (95% CI: 0.49-1.71, p = 0.78), the uncorrected OR of ventilating >10 breaths min(-1) for survival to hospital discharge was 0.91 (95% CI: 0.30-2.77, p = 0.78), and the uncorrected OR of ventilating >10 breaths min(1) for one-year survival with a favourable neurological outcome was 0.59 (95% CI: 0.19-1.87, p = 0.32). A logistic regression with continuous ventilation rate showed no significant relation with ROSC, and a ROC curve for ROSC showed a poor predictive performance (AUC: 0.52, 95% CI: 0.46-0.58), suggesting no other adequate cut-off value for ventilation rate. Conclusion: A ventilation rate <= 10 breaths min(-1) was not associated with significantly improved outcomes compared to a ventilation rate >10 breaths min(-1). No other adequate cut-off value could be proposed.

【 授权许可】

Free