Comparison of Returning of Spontaneous Circulation between Mechanical Ventilation and Manual Ventilation among Patients with Cardiac Arrest
Keywords:
cardiopulmonary resuscitation (CPR), mechanical ventilation, manual ventilationAbstract
Backgrounds During the coronavirus outbreak situation, cardiopulmonary resuscitation (CPR) has the potential to cause the spread of the coronavirus from the distribution of droplets, secretions from the mouth and nose of the patient. We recommended to reduce the diffusion of aerosols, secretions from the mouth and nose of patients by using a mechanical ventilator after intubation instead of manual ventilation.
Objectives This research aimed to determine the difference in resuscitation outcomes, vital signs, and post-resuscitation laboratory results in cardiac arrest patients receiving mechanical ventilation compared to those receiving manual ventilation.
Methods The study period was from 2019-2022. We studied 106 patients who were ventilated by mechanical ventilation during the coronavirus outbreak (ventilator setup FiO 2 1.0, respiratory rate 10 bpm, low tidal volume) compared to a group of 96 patients receiving manual ventilation.
Results The researchers conducted an analysis by dividing patients into two groups : cardiac arrest patients who were ventilated by mechanical ventilation and those who were ventilated by manual ventilation. We found that the median CPR duration (30.00±10.812 minute, 30.00±11.600 minute, P value 0.458), systolic blood pressure (0.00±52.867 mmHg, 0.00±57.780 mmHg, P value 0.332), diastolic blood pressure (0.00±30.981mmHg, 0.00±36.219mmHg, P value 0.293), heart rate (0.00±56.079 beat/minute, 0.00±54.772 beat/ minute, P value 0.806), O 2 saturation (0.00±46.941%, 0.00±54.772%, P value 0.806) were no statistical significant difference, and venous blood gas results PvO 2 (34.00±60.29mmHg, 23.00±16.971mmHg, P value 0.319), PvCO 2 (7.810±3.272mmHg, 4.930±9.617mmHg, P value 0.076), lactate (6.760±5.738mmol/L, 5.095±0.784mmol/L, P value 0.884) were no statistical significant difference. But the researchers found that venous blood gas pH (6.914±0.231, 7.210±0.069, P value 0.047) were statistical significant different. There was no difference in the results of resuscitation including return of spontaneous circulation (ROSC) odds ratio(OR) 1.262(95%CI 0.709-2.247, P value = 0.429) and use of blood pressure stimulating drugs OR 0.870(95%CI 0.456- 1.660, P value = 0.672).
Conclusions Return of spontaneous circulation, there was no difference between patients receiving mechanical ventilation and manual ventilation.
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