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Bag-Valve-Mask versus Laryngeal Mask Airway Ventilation in Cardiopulmonary Resuscitation with Continuous Compressions: A Simulation Study

Published online by Cambridge University Press:  01 February 2021

Zerrin Defne Dundar Open the ORCID record for Zerrin Defne Dundar [Opens in a new window] ,
Mustafa Kursat Ayranci Open the ORCID record for Mustafa Kursat Ayranci [Opens in a new window] ,
Sedat Kocak  and
Abdullah Sadik Girisgin
Zerrin Defne Dundar*
Affiliation:
Emergency Medicine Department, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
Mustafa Kursat Ayranci
Affiliation:
Emergency Medicine Department, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
Sedat Kocak
Affiliation:
Emergency Medicine Department, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
Abdullah Sadik Girisgin
Affiliation:
Emergency Medicine Department, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
*
Correspondence: Zerrin Defne Dundar, MD, Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi, Acil Tıp ABD 42080 Meram/Konya, Turkey, E-mail: zerdef@hotmail.com
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Abstract

Introduction:

The 2017 International Liaison Committee on Resuscitation (ILCOR) guideline recommends that Emergency Medical Service (EMS) providers can perform cardiopulmonary resuscitation (CPR) with synchronous or asynchronous ventilation until an advanced airway has been placed. In the current literature, limited data on CPR performed with continuous compressions and asynchronous ventilation with bag-valve-mask (BVM) are available.

Study Objective:

In this study, researchers aimed to compare the effectiveness of asynchronous BVM and laryngeal mask airway (LMA) ventilation during CPR with continuous chest compressions.

Methods:

Emergency medicine residents and interns were included in the study. The participants were randomly assigned to resuscitation teams with two rescuers. The cross-over simulation study was conducted on two CPR scenarios: asynchronous ventilation via BVM during a continuous chest compression and asynchronous ventilation via LMA during a continuous chest compression in cardiac arrest patient with asystole. The primary endpoints were the ventilation-related measurements.

Results:

A total of 92 volunteers were included in the study and 46 CPRs were performed in each group. The mean rate of ventilations of the LMA group was significantly higher than that of the BVM group (13.7 [11.7-15.7] versus 8.9 [7.5-10.3] breaths/minute; P <.001). The mean volume of ventilations of the LMA group was significantly higher than that of the BVM group (358.4 [342.3-374.4] ml versus 321.5 [303.9-339.0] ml; P = .002). The mean minute ventilation volume of the LMA group was significantly higher than that of the BVM group (4.88 [4.15-5.61] versus 2.99 [2.41-3.57] L/minute; P <.001). Ventilations exceeding the maximum volume limit occurred in two (4.3%) CPRs in the BVM group and in 11 (23.9%) CPRs in the LMA group (P = .008).

Conclusion:

The results of this study show that asynchronous BVM ventilation with continuous chest compressions is a reliable and effective strategy during CPR under simulation conditions. The clinical impact of these findings in actual cardiac arrest patients should be evaluated with further studies at real-life scenes.

Keywords

bag-valve-maskcardiopulmonary resuscitationcontinuous compressionlaryngeal mask airwayventilation
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 36 , Issue 2 , April 2021 , pp. 189 - 194
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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