title: Effect of continuous oxygen insufflation on induced-gastric air volume during cardiopulmonary resuscitation in a cadaveric model.
abstract: BACKGROUND
  The main objective of this study was to compare the volume of gas insufflated in the stomach with continuous external chest compressions plus continuous oxygen insufflation (C-CPR) versus standard-CPR (S-CPR) which alternates external chest compressions and synchronized positive insufflations through a bag-valve-mask with a 30/2 ratio. The secondary objective was to compare upper airway pressures (intratracheal and intramask) generated during continuous oxygen insufflation.
  
  
  METHODS
  Open, prospective, randomized, cross over, comparative, non-inferiority study. CPR was performed for six minutes periods, on seven fresh human corpses, with C-CPR or S-CPR in a random order. Before each CPR period, the stomach was completely emptied through the gastrostomy tube, and then 200 mL of air was injected in the stomach to be sure it was not collapsed. The gastric volume was measured at the end of each intervention. Intratracheal and intramask pressures were recorded continuously during C-CPR. Results were provided as mean ± standard deviation. Statistical analyses were done with a paired student t test.
  
  
  RESULTS
  Induced-gastric inflation was lower with C-CPR (221 ± 130 mL) than with S-CPR (5401 ± 2208 mL, p = 0.001). Throughout C-CPR, no difference was found between the intratracheal and intramask pressures (4.4 ± 1.2; 4.0 ± 0.8 cmH2O, respectively, p = 0.45).
  
  
  CONCLUSIONS
  This human cadaver study demonstrates that continuous oxygen insufflation induced less gastric inflation than intermittent insufflation during CPR.
authors.affiliation: Univ Paris Diderot, Sorbonne Paris Cité, UMRS 942, AP-HP, Hôpital Lariboisière, Service des Urgences, F-75018 Paris, France. Electronic address: dr.nicolas.segal@gmail.com.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Segal
authors.affiliation: Université Claude Bernard-Lyon 1, UMR T 9405, Groupement Hospitalier Lyon-Sud, Pôle des Urgences, Unité de Chirurgie d'Urgence, F-69495 Pierre-Bénite, France.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Voiglio
authors.affiliation: Université Claude Bernard-Lyon 1, Groupement Hospitalier Edouard Herriot, Pôle des Urgences, SAMU de Lyon, F-69437 Lyon, France.
authors.forename: Djamila
authors.initials: D
authors.lastname: Rerbal
authors.affiliation: Brigade des Sapeurs-Pompiers de Paris, Service Médical d'Urgence, F-75017 Paris, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Jost
authors.affiliation: Université Claude Bernard-Lyon 1, Groupement Hospitalier Edouard Herriot, Pôle des Urgences, SAMU de Lyon, F-69437 Lyon, France.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Dubien
authors.affiliation: Brigade des Sapeurs-Pompiers de Paris, Service Médical d'Urgence, F-75017 Paris, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Lanoe
authors.affiliation: Université Claude Bernard-Lyon 1, Groupement Hospitalier Edouard Herriot, Pôle des Urgences, SAMU de Lyon, F-69437 Lyon, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Dhers
authors.affiliation: Brigade des Sapeurs-Pompiers de Paris, Service Médical d'Urgence, F-75017 Paris, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Tourtier
authors.affiliation: Univ Paris Diderot, Sorbonne Paris Cité, UMRS 942, AP-HP, Hôpital Lariboisière, Service des Urgences, F-75018 Paris, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Plaisance
authors.affiliation: Université Claude Bernard-Lyon 1, Groupement Hospitalier Edouard Herriot, Pôle des Urgences, SAMU de Lyon, F-69437 Lyon, France.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Gueugniaud
mesh_terms: D000368:Aged; D000388:Air; D002102:Cadaver; D016887:Cardiopulmonary Resuscitation; D018592:Cross-Over Studies; D006801:Humans; D007327:Insufflation / Q000295:instrumentation; D010100:Oxygen / Q000008:administration & dosage*; D013270:Stomach
chemical_list: D010100:Oxygen
keywords: *Insufflation; Cardiopulmonary resuscitation; Cardiopulmonary resuscitation/therapy; Continuous external chest compression, Continuous oxygen insufflation